Original method for evaluating the microcirculatory bed of the peripapillary optic nerve head in primary open-angle glaucoma

Abstract

PURPOSE. To study the state of microcirculation in the peripapillary region of the optic nerve head (ONH) using an original method of objective assessment in the absence of the necessary licensed software.METHODS. A total of 30 patients (30 eyes) were included. The main group consisted of patients with early (subgroup 1, 10 eyes) and advanced (subgroup 2, 10 eyes) stages of primary open-angle glaucoma (POAG), the control group — individuals without history of ophthalmic complications (10 eyes). The peripapillary region of the ONH was examined using optical coherence tomography angiography (OCT-A). An original script was written in Python language for assessment of the prevalence of the vascular bed on the scans, analyzing an array of elements with brightness data.RESULTS. Subgroup 2 differed most from subgroup 1 in capillary deficiency in the superficial layer. Differences between the groups were found in the capillary network density in the superficial and deep vascular plexuses, in the superficial layer they were statistically significant (subgroup 1 — 27444.5±1372.2; subgroup 2 — 14126.5±706.3; control group — 45198.5±2259.9). Correlation analysis in advanced glaucoma confirmed almost complete atrophy of the superficial layer, which became almost "transparent" to the device.CONCLUSION. The developed method, based on the capabilities of OCT-A and additional machine analysis, can be used in the complex diagnostics of POAG both to confirm the stage of the pathological process and to assess the effectiveness of the ongoing therapeutic measures.