Journal of Current Glaucoma Practice

Register      Login

VOLUME 13 , ISSUE 1 ( January-April, 2019 ) > List of Articles

Original Article

Peripapillary Vessel Density and Retinal Nerve Fiber Layer Thickness in Patients with Unilateral Primary Angle Closure Glaucoma with Superior Hemifield Defect

Keywords : OCT angiography, Primary angle-closure, Primary angle-closure glaucoma, Retinal nerve fiber layer thickness, RPC vessel density, Superior hemifield loss

Citation Information : Peripapillary Vessel Density and Retinal Nerve Fiber Layer Thickness in Patients with Unilateral Primary Angle Closure Glaucoma with Superior Hemifield Defect. J Curr Glaucoma Pract 2019; 13 (1):21-27.

DOI: 10.5005/jp-journals-10078-1247

License: CC BY-NC 4.0

Published Online: 00-04-2019

Copyright Statement:  Copyright © 2019; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Purpose: To evaluate peripapillary retinal nerve fiber layer (RNFL) thickness and radial peripapillary capillary (RPC) vessel density (VD) in the eyes with unilateral primary angle-closure glaucoma (PACG) with the visual field (VF) defect confined to the superior hemifield and compare these parameters with the corresponding perimetrically intact regions of the fellow eye with primary angle-closure (PAC) and normal control eyes, using optical coherence tomography angiography (OCTA). Materials and methods: This prospective, cross-sectional study included 28 eyes with unilateral PACG, with VF defects restricted to the superior hemifield, 28 fellow eyes with PAC, and 30 age-matched normal controls. Peripapillary RNFL thickness and RPC VD were measured in the eight peripapillary sectors, using OCTA, and these parameters were compared among the corresponding sectors of PACG, PAC, and healthy eyes using analysis of variance (ANOVA) with the Bonferroni post hoc analysis. Results: In PACG eyes, there was a significant difference in the RNFL thickness (p < 0.0001) and RPC VD (p = 0.001) between the superior and the inferior hemifield. In PAC and normal eyes, there was no significant difference in the RNFL thickness and RPC VD between the superior and the inferior hemifield. Within the perimetrically intact regions of the PACG eyes, the mean RNFL thickness was significantly reduced in the superonasal (SN) and upper nasal (UN) sectors (p = 0.02), but the VD did not show any significant difference, when compared to the fellow PAC eyes. In PACG eyes, the mean RNFL thickness was significantly reduced in the perimetrically normal SN and UN sectors (p < 0.0001) and the VD was reduced in the UN sector (p = 0.01), when compared to the normal eyes. When comparing the peripapillary sectors of the PAC and healthy eyes, RNFL thickness was reduced in UN (p = 0.02), lower nasal (LN) (p = 0.01), inferonasal (IN) (p = 0.02), and inferotemporal (IT) sectors (p = 0.03) and there was no significant difference in the VD in any of the sectors. Inside disc capillaries were preserved in all the three groups. Conclusion: Sector-wise RNFL thinning seems to precede the vascular changes and functional loss in the PAC and PACG eyes.


PDF Share
  1. Quigley HA, Addicks EM, et al. Optic nerve damage in human glaucoma. III. Quantitative correlation of nerve fiber loss and visual field defect in glaucoma, ischemic neuropathy, papilledema, and toxic neuropathy. Arch Ophthalmol 1982;100:135–146. DOI: 10.1001/archopht.1982.01030030137016.
  2. Rao HL, Kadambi SV, et al. Diagnostic ability of peripapillary vessel density measurements of optical coherence tomography angiography in primary open-angle and angle-closure glaucoma. Br J Ophthalmol 2017;101:1066–1070. DOI: 10.1136/bjophthalmol-2016-309377.
  3. Mansoori T, Sivaswamy J, et al. Radial Peripapillary Capillary Density Measurement Using Optical Coherence Tomography Angiography in Early Glaucoma. J Glaucoma 2017;26:438–443. DOI: 10.1097/IJG.0000000000000649.
  4. Liu L, Jia Y, et al. Optical Coherence Tomography Angiography of the Peripapillary Retina in Glaucoma. JAMA Ophthalmol 2015;133:1045–1052. DOI: 10.1001/jamaophthalmol.2015.2225.
  5. Jia Y, Morrison JC, et al. Quantitative OCT angiography of optic nerve head blood flow. Biomed Opt Express 2012;3:3127–3137. DOI: 10.1364/BOE.3.003127.
  6. Mansoori T, Sivaswamy J, et al. Measurement of Radial Peripapillary Capillary Density in the Normal Human Retina Using Optical Coherence Tomography Angiography. J Glaucoma 2017;26:241–246. DOI: 10.1097/IJG.0000000000000594.
  7. Jia Y, Tan O, et al. Split-spectrum amplitude decorrelation angiography with optical coherence tomography. Opt Express 2012;20:4710–4725. DOI: 10.1364/OE.20.004710.
  8. Rao HL, Pradhan ZS, et al. Regional Comparisons of Optical Coherence Tomography Angiography Vessel Density in Primary Open- Angle Glaucoma. Am J Ophthalmol 2016;171:75–83. DOI: 10.1016/j.ajo.2016.08.030.
  9. Chen C, Bojikian KD, et al. Peripapillary Retinal Nerve Fiber Layer Vascular Microcirculation in Eye with Glaucoma and Single-Hemifield Visual Field Loss. JAMA Ophthalmol 2017;135:461–468. DOI: 10.1001/jamaophthalmol.2017.0261.
  10. Yarmohammadi A, Zangwill LM, et al. Peripapillary and Macular Vessel Density in Patients with Glaucoma and Single-Hemifield Visual Field Defect. Ophthalmology 2017;124:709–719. DOI: 10.1016/j.ophtha.2017.01.004.
  11. Akagi T, Iida Y, et al. Microvascular Density in Glaucomatous Eyes with Hemifield Visual Field Defects: An Optical Coherence Tomography Angiography Study. Am J Ophthalmol 2016;168:237–249. DOI: 10.1016/j.ajo.2016.06.009.
  12. Pradhan ZS, Dixit S, et al. A Sectoral Analysis of Vessel Density Measurements in Perimetrically Intact Regions of Glaucomatous Eyes: An Optical Coherence Tomography Angiography Study. J Glaucoma 2018;27:525–531. DOI: 10.1097/IJG.0000000000000950.
  13. Foster PJ, Buhrmann R, et al. The definition and classification of glaucoma in prevalence surveys. Br J Ophthalmol 2002;86:238–242. DOI: 10.1136/bjo.86.2.238.
  14. Anderson DR, Patella VM. Automated static perimetry, 2nd ed. St. Louis: Mosby; 1999. pp. 121–136.
  15. Rao HL, Pradhan ZS, et al. Determinants of Peripapillary and Macular Vessel Densities Measured by Optical Coherence Tomography Angiography in Normal Eyes. J Glaucoma 2017;26:491–497. DOI: 10.1097/IJG.0000000000000655.
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.