Progression in Open-Angle Glaucoma with Myopic Disc and Blood Flow in the Optic Nerve Head and Peripapillary Chorioretinal Atrophy Zone

Kiyota, Naoki; Shiga, Yukihiro; Takahashi, Nana; Yasuda, Masayuki; Omodaka, Kazuko; Tsuda, S.; Kunikata, Hiroshi; Nakazawa, Toru

doi:10.1016/j.ogla.2020.03.005

Cited by 8 publications

(7 citation statements)

References 54 publications

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“…Some glaucoma patients show parafoveal scotomas even at an early stage, and suggested risk factors for this include myopia and BF-associated factors [ 30 – 33 ]. We previously examined this so-called “vascular theory” and found that temporal ONH-tissue MBR and temporal PPA-tissue MBR are correlated with each other; reduction of these parameters contributes to BCVA loss and central visual-field defect progression in eyes with glaucoma and a myopic disc [ 9 , 10 , 34 ]. This study suggests that BF impairment associated with ICCs and sinkholes might also affect BF in the adjacent ONH.…”

Section: Discussionmentioning

confidence: 99%

“…Tissue-area MBR has been reported to be a good indicator of BF in the deep ONH [ 20 , 21 ]. We set another ROI, which was slightly larger than the ROI for the ONH and was superimposed over it and aligned on the nasal edge, and then used the LSFG analysis software to subtract the larger ROI from the ROI for the ONH, thereby obtaining a measurement of tissue-area MBR in the crescent PPA zone [ 10 ]. Additionally, in this study, we set a novel ROI around the ICC area and subtracted the ROIs of other areas from it, thereby obtaining a measurement of tissue-area MBR in the ICC zone.…”

Section: Methodsmentioning

confidence: 99%

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Factors associated with intrachoroidal cavitation and sinkhole formation in eyes with glaucomatous visual-field defects

Yamaguchi,

Kiyota,

Takahashi

et al. 2023

Graefes Arch Clin Exp Ophthalmol

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Purpose To investigate factors associated with intrachoroidal cavitation (ICC) and sinkhole formation in eyes with glaucomatous visual-field defects. Methods This retrospective, cross-sectional study enrolled a total of 2808 eyes of 1482 patients who were diagnosed/treated for glaucoma and underwent swept-source optical coherence tomography (OCT). We first determined the prevalence of ICCs and sinkholes and their locations. Next, we selected one eye from each patient and compared the clinical characteristics of eyes with and without ICCs. Finally, in eyes with ICCs, we compared the clinical characteristics of eyes with and without sinkholes. Blood flow (BF), represented by laser speckle flowgraphy–measured tissue-area mean blur rate (MBR), was measured in the temporal optic nerve head (ONH), temporal peripapillary chorioretinal atrophy (PPA) zone, and in the ICC zone. ICC area and angle were analyzed in OCT en-face images. Mean deviation and total deviation in the central area (TD-central) were measured with Humphrey visual-field testing. Results A total of 86 eyes (3.1%) had ICCs and 52 eyes (1.9%) had sinkholes. ICC eyes had a lower spherical equivalent and longer axial length (AL) than non-ICC eyes (P < 0.05). Patients with eyes with sinkholes were more elderly and had worse best-corrected visual acuity, worse TD-central, a larger ICC, and lower tissue-area MBR in the temporal ONH, temporal PPA zone, and ICC zone (P < 0.05). Conclusion In eyes with glaucoma, AL elongation might be linked to ICC formation. Sinkhole formation might be associated with ICC enlargement, impaired ocular BF, and impaired retinal structure and function involving the central area.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Factors associated with intrachoroidal cavitation and sinkhole formation in eyes with glaucomatous visual-field defects

Yamaguchi,

Kiyota,

Takahashi

et al. 2023

Graefes Arch Clin Exp Ophthalmol

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“…Vascular factors have been hypothesized to contribute to the development and progression of glaucoma ( 2 ). It is believed that these factors are especially significant in NTG patients, where optic nerve damage is believed to be a result of vascular dysregulation and poor blood supply ( 16 , 38 – 40 ).…”

Section: Discussionmentioning

confidence: 99%

Investigating the macular choriocapillaris in early primary open-angle glaucoma using swept-source optical coherence tomography angiography

et al. 2022

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IntroductionThere has been a growing interest in the role of vascular factors in glaucoma. Studies have looked at the characteristics of macular choriocapillaris in patients with glaucoma but with conflicting results. Our study aims to use swept-source optical coherence tomography angiography (SS-OCTA) to evaluate macular choriocapillaris metrics in normal participants and compare them with patients with early primary open-angle glaucoma (POAG) (mean deviation better than −6dB).MethodsIn this prospective, observational, cross-sectional study, 104 normal controls (157 eyes) and 100 patients with POAG (144 eyes) underwent 3 mm × 3mm imaging of the macula using the Plex Elite 9000 (Zeiss Meditec, Dublin, CA, USA). Choriocapillaris OCTA images were extracted from the device’s built-in review software and were subsequently evaluated for the density and size of choriocapillaris flow deficits.ResultsAfter adjusting for confounding factors, the density of flow deficits was independently higher in those aged 53 years and above (P ≤ 0.024) whereas the average flow deficit size was significantly larger in those aged 69 years and above (95% CI = 12.39 to 72.91; P = 0.006) in both normal and POAG patients. There were no significant differences in the density of flow deficits (P = 0.453) and average flow deficit size (P = 0.637) between normal and POAG participants.ConclusionOur study found that macular choriocapillaris microvasculature on SS-OCTA is unaltered by subjects with POAG. This suggests that OCTA macular choriocapillaris may not be potentially helpful in differentiating early glaucoma from healthy eyes.

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“…In comparison with color Doppler imaging ( 9 , 10 , 23 ), the advantages of LSFG are the high reproducibility and objectivity of measurements ( 27 , 28 ). Furthermore, the penetrating long-wavelength laser used in LSFG may accurately examine the ONH without effects caused by the configuration of the disc.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Microcirculation in Optic Nerve Head Using Laser Speckle Flowgraphy in Active Thyroid Eye Disease

Tsai

Chu

et al. 2022

BioMed Research International

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Background. Laser speckle flowgraphy (LSFG) can be used to estimate optic nerve blood flow. This study used LSFG to evaluate optic nerve microcirculation in patients with thyroid eye disease (TED). Methods. This was a retrospective review of patients with active TED who underwent LSFG between October 2020 and June 2021. The mean blur rate (MBR) for different severities of active TED was analyzed by one-way analysis of variance (ANOVA). Results. A total of 30 patients (60 eyes) with a diagnosis of active TED who underwent LSFG were included. The mean age was 49 (range, 33–74) years. Mean best-corrected visual acuity was the worst in the group with sight-threatening active TED ( 0.29 ± 0.33 logarithm of the minimum angle of resolution, p = 0.01 ). The MBR-overall was the highest in the group with mild active TED ( 28.5 ± 2.7 ), followed by that in the moderate to severe ( 23.6 ± 3.2 ), and in the sight-threatening ( 20.2 ± 4.3 ) active TED groups ( p < 0.001 ). The MBR-vessel was 57.1, 47.0, and 39.3 in the mild, moderate to severe, and sight-threatening active TED groups, respectively ( p < 0.001 ). The MBR-tissue was 16.9, 14.4, and 12.0 in the mild, moderate to severe, and sight-threatening active TED groups, respectively ( p < 0.001 ). Conclusions. This study demonstrates that optic nerve blood flow is lower with more severe active TED. In addition, LSFG is an effective, objective, and noninvasive method for evaluating the severity of TED.

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Progression in Open-Angle Glaucoma with Myopic Disc and Blood Flow in the Optic Nerve Head and Peripapillary Chorioretinal Atrophy Zone

Cited by 8 publications

References 54 publications

Factors associated with intrachoroidal cavitation and sinkhole formation in eyes with glaucomatous visual-field defects

Factors associated with intrachoroidal cavitation and sinkhole formation in eyes with glaucomatous visual-field defects

Investigating the macular choriocapillaris in early primary open-angle glaucoma using swept-source optical coherence tomography angiography

Evaluation of Microcirculation in Optic Nerve Head Using Laser Speckle Flowgraphy in Active Thyroid Eye Disease

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