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Comparison of Peripapillary Choroidal Microvasculature Dropout in Primary Open Angle, Primary Angle Closure and Pseudoexfoliation Glaucoma.

Research paper by Youn Hye YH Jo, Kyung Rim KR Sung, Joong Won JW Shin

Indexed on: 06 Sep '20Published on: 06 Sep '20Published in: Journal of glaucoma



Abstract

The prevalence of choroidal microvascular dropout was significantly higher in primary open angle glaucoma than primary angle closure or pseudoexfoliation glaucoma in early stage. However, in advanced stage, it did not differ among three groups. To compare the prevalence of peripapillary choroidal microvascular dropout (CMvD) in primary open angle glaucoma (POAG), primary angle closure glaucoma (PACG) and pseudoexfoliation glaucoma (PXG). Presence of peripapillary CMvD was identified using optical coherence tomography angiography (OCT-A, AngioVue/RTVue-XR) imaging of the choroid in 186 eyes from 186 subjects (age and visual field (VF) mean deviation (MD) matched; 62 POAG, 62 PACG and 62 PXG eyes). Prevalence of CMvD was compared among glaucoma types in early and moderate to advanced disease, as divided by VF MD (-6 dB). The association between glaucoma type and presence of CMvD was evaluated using logistic regression analysis. Prevalence of CMvD was significantly different between glaucoma types in early stage disease (PACG 7.5%, PXG 25% and POAG 46.3%, P<0.001), but it did not differ between glaucoma types in eyes with moderate to advanced disease (PACG 59.1%, PXG 68.2% and POAG 81%; P=0.331). After adjusting for age, gender, the β-zone peripapillary atrophy/disc ratio and glaucoma severity (VF MD), the CMvD odds ratio was 7.50 times greater in POAG than in PACG (P=0.001). CMvD was more common in POAG relative to both PACG and PXG, especially in early stage disease. This finding suggested a role for ischemic injury in the pathogenesis of POAG.

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