Verändert sich die foveale avaskuläre Zone beim Glaukom?

Lommatzsch, Claudia; Heinz, Carsten; Koch, Jörg; Heimes, B.; Hahn, Ursula; Grisanti, Swaantje

doi:10.1055/a-1080-2900

Cited by 3 publications

(1 citation statement)

References 31 publications

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“…Differences in perfusion density (PD) in glaucomatous eyes, more precisely reduced macular, peripapillary and papillary vascular densities compared to healthy eyes, have been demonstrated by OCTA [4][5][6]8]. The OCTA also shows the presence of an enlarged perimeter of the FAZ with reduced circularity in glaucomatous eyes compared to healthy eyes, while no difference could be found in the size of the FAZ [10][11][12]. Since vascular dysfunction plays an important role in the pathogenesis of glaucoma disease, studies have focused on the different manifestations of vascular dysfunction in the different entities of glaucoma.…”

Section: Introductionmentioning

confidence: 99%

Macular, papillary and peripapillary perfusion densities measured with optical coherence tomography angiography in primary open angle glaucoma and pseudoexfoliation glaucoma

Cornelius

Pilger

Riechardt

et al. 2021

Graefes Arch Clin Exp Ophthalmol

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Purpose To compare the blood flow situation in primary open-angle glaucoma (POAG) and pseudoexfoliation glaucoma (PXG) using optical coherence tomography angiography (OCTA). Methods In this prospective study a total of 26 POAG and 23 PXG eyes were included. All patients underwent a complete ophthalmological examination including standard automated perimetry, stereoscopic photographs of the optic disc, peripapillary retinal nerve fibre layer analysis and examination of vascular parameters of the optic nerve head (ONH), the peripapillary region and macula using OCTA. In addition to the vascular parameters recorded by the device, the vascular images were graphically evaluated using Image J. All recorded vascular parameters were compared between both groups and correlated to structural and functional parameters. Results The mean superficial perifoveal plexus perfusion density (PD) was significantly lower in PXG eyes than compared to POAG eyes using OCTA (32.57% ± 3.57% vs. 34.92% ± 2.11%, p = 0.007). The mean PD parameters for the superficial peripapillary plexus (40.98% ± 3.04% vs. 42.09% ± 2.29%, p = 0.152) as well as the size of the foveal avascular zone (FAZ) (0.23 mm2 ± 0.1 mm2 vs. 0.23 mm2 ± 0.09 mm2) did not differ between both groups. Additional graphic evaluation using Image J showed no significant difference for superficial perifoveal plexus PD (32.97% ± 1.11% vs. 33.35% ± 0.95%, p = 0.194) and peripapillary plexus PD (46.65% ± 0.83% vs. 46.95% ± 0.5%, p = 0.127) between the groups. Retinal nerve fibre layer (RNFL) thickness correlated significantly with peripapillary plexus PD for both OCTA data and Image J data (p < 0.001, p = 0.032). Conclusion The severity of the glaucoma seems to be crucial for peripapillary and macular perfusion densities, and not the form of glaucoma. An additional graphic evaluation is a possible step that could be implemented to improve the comparability of OCTA scans and to optimize the possibility of quantitative perfusion analysis in the case of deviating quality criteria.

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Section: Introductionmentioning

confidence: 99%

Macular, papillary and peripapillary perfusion densities measured with optical coherence tomography angiography in primary open angle glaucoma and pseudoexfoliation glaucoma

Cornelius

Pilger

Riechardt

et al. 2021

Graefes Arch Clin Exp Ophthalmol

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Elevated endothelin-1 levels as risk factor for an impaired ocular blood flow measured by OCT-A in glaucoma

Lommatzsch

Rothaus

Schopmeyer

et al. 2022

Sci Rep

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The purpose of this study was to ascertain whether a correlation exists between glaucoma-associated alteration of ocular vascular haemodynamics and endothelin-1 (ET-1) levels exist. Eyes of patients with cataract (n = 30) or glaucoma (n = 68) were examined with optical coherence tomography (OCT) and OCT-angiography (OCT-A; AngioVue™-RTVue-XR; Optovue, Fremont, California, USA). The peripapillary and the macular vessel density (VD) values were measured. Inferior and superior retinal nerve fibre layer (RNFL) thickness loss was used for further OCT staging. Aqueous humour of the examined eye and plasma were sampled during cataract or glaucoma surgery and analysed by means of ELISA to determine their ET-1 level. Glaucoma eyes are characterised by reductions in RNFL thickness and VD that correlate significantly with the OCT GSS score. Peripheral and ocular ET-1 level were significantly elevated in patients with glaucoma and correlate positively with the OCT-GSS score of the entire study population. Peripapillary and macula VD of glaucoma patients correlates negatively with plasma ET-1 levels. Multivariable analysis showed a subordinate role of intraocular pressure predictive factor for impaired retinal blood flow compared with plasma ET-1 level in glaucoma. Peripheral ET-1 level serves as risk factor for detection of ocular blood flow changes in the optic nerve head region of glaucomatous eyes.

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Microvascular and Structural Alterations of the Macula in Early to Moderate Glaucoma: An Optical Coherence Tomography-Angiography Study

Lever

Glaser²,

Chen

et al. 2021

JCM

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In glaucoma, macular optical coherence tomography (OCT) typically shows a thinning of the three inner segments and OCT-angiography (OCTA) a reduction of the vascular density (VD). It is still unclear if glaucoma directly affects macular VD. This retrospective study included 31 glaucoma patients of early and moderate stage (GS1, GS2, Mills et al.) and 39 healthy individuals. Macular segments’ thickness and superficial and deep plexus vascular density (VD) were obtained using spectral-domain OCT and OCTA, respectively. One-way analysis of variance (ANOVA) was used to compare healthy controls and glaucoma patients according to their glaucoma stage. Using correlation analyses, the association between glaucoma and either OCT or OCTA parameters was evaluated. A glaucoma stage-stratified linear regression analysis was then performed. Inner macular segment and whole retinal thickness were reduced in GS1 and GS2 patients compared to healthy controls (e.g., ganglion cell layer GCL: controls: 47.9 ± 7.4, GS1: 45.8 ± 5.1, GS2: 30.6 ± 9.4, ANOVA: p < 0.0001). Regarding OCTA-parameters, the VD of both segmentation levels was reduced in glaucoma patients, particularly when comparing GS2 patients with controls (superficial plexus: p = 0.004) and GS2 with GS1 (p = 0.0008). Linear regression revealed an association between these parameters and the presence of glaucoma (for superior plexus: R2 = 0.059, p = 0.043). Finally, a correlation between macular segment thickness and VD was observed, but with a strength increasing with glaucoma severity (GCL and superior plexus VD: controls: R2 = 0.23, GS1 R2 = 0.40, GS2 R2 = 0.76). Despite the glaucoma-independent correlation between macular segment thickness and VD, disease severity strengthens this correlation. This consideration suggests that glaucoma directly influences OCT and OCTA parameters individually.

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Verändert sich die foveale avaskuläre Zone beim Glaukom?

Cited by 3 publications

References 31 publications

Macular, papillary and peripapillary perfusion densities measured with optical coherence tomography angiography in primary open angle glaucoma and pseudoexfoliation glaucoma

Macular, papillary and peripapillary perfusion densities measured with optical coherence tomography angiography in primary open angle glaucoma and pseudoexfoliation glaucoma

Elevated endothelin-1 levels as risk factor for an impaired ocular blood flow measured by OCT-A in glaucoma

Microvascular and Structural Alterations of the Macula in Early to Moderate Glaucoma: An Optical Coherence Tomography-Angiography Study

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