Topographic correlation between juxtapapillary choroidal thickness and parapapillary deep-layer microvasculature dropout in primary open-angle glaucoma

Br J Ophthalmol. 2018 Aug;102(8):1134-1140. doi: 10.1136/bjophthalmol-2017-311136. Epub 2017 Nov 3.

Abstract

Purpose: To investigate the topographic relationship between parapapillary deep-layer microvasculature dropout (MvD) as assessed by optical coherence tomography (OCT) angiography (OCTA) and the juxtapapillary choroidal thickness (JPCT) in primary open-angle glaucoma (POAG).

Methods: A total of 194 eyes (138 POAG and 56 control eyes) having parapapillary atrophy (PPA) were imaged using the swept-source OCT and OCTA to examine the microstructure of PPA and measure the JPCT, and to determine the presence of the MvD. MvD was defined as a focal sectoral capillary dropout without any visible microvascular network identified in the parapapillary deep-layer in the en face OCTA images.

Results: JPCT was smaller in the POAG group than control group at 6-, 6.5-, 7- and 7.5-o'clock meridians (all p≤0.002). When POAG eyes were classified into those with parapapillary γ-zone and those with only β-zone without γ-zone, the mean JPCT was significantly smaller in the latter (p=0.027). The JPCT differed between with and without MvD only in eyes with a γ-zone: the JPCT was smaller in the eyes having MvD at 7- and 7.5-o'clock meridians (both p=0.001), where MvD was detected most frequently. However, such a difference was not observed in the eyes with only β-zone without the γ-zone at any of the meridians.

Conclusions: Localised reductions in JPCT were observed at the location of MvD in POAG eyes with parapapillary γ-zone. Such a correlation was not observed in the POAG eyes with only β-zone, but the mean JPCT was significantly smaller in this group.

Keywords: choroid; glaucoma; imaging.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Choroid / blood supply
  • Choroid / pathology*
  • Ciliary Arteries / pathology*
  • Female
  • Fluorescein Angiography
  • Glaucoma, Open-Angle / physiopathology*
  • Humans
  • Intraocular Pressure
  • Male
  • Microvessels / pathology
  • Middle Aged
  • Nerve Fibers / pathology
  • Optic Atrophy / physiopathology*
  • Optic Disk / blood supply*
  • Prospective Studies
  • Retinal Ganglion Cells / pathology
  • Tomography, Optical Coherence
  • Visual Fields