Structural and Functional Associations of Macular Microcirculation in the Ganglion Cell-Inner Plexiform Layer in Glaucoma Using Optical Coherence Tomography Angiography

Overview

Journal J Glaucoma

Date 2018 Feb 3

PMID 29394201

Citations 28

Authors

Grace M Richter

Ingy Madi

Zhongdi Chu

Bruce Burkemper

Ryuna Chang

Arman Zaman

Beau Sylvester

Alena Reznik

Amir Kashani

Ruikang K Wang

Rohit Varma

Affiliations

Soon will be listed here.

Abstract

Purpose: To quantify retinal microvasculature within the macular ganglion cell-inner plexiform layer (GCIPL) in primary open-angle glaucoma (POAG) and normal eyes, determine association of vessel parameters with structural and functional measures, and report diagnostic accuracy of vessel parameters.

Methods: POAG and normal patients underwent 6×6 mm macula scans [Angioplex optical coherence tomography angiography (OCTA); Cirrus HD-OCT 5000]; and Humphrey Field Analyzer II-i 24-2 visual field (VF). Prototype software performed semiautomatic segmentation to create GCIPL en face images, and quantified vessel area density (VAD), vessel skeleton density (VSD), and vessel complexity index (VCI) for the macula (globally, hemifields, and 6 focal sectors). Linear regression assessed association of OCTA parameters with VF mean deviation (MD) and GCIPL thickness globally and focally.

Results: A total of 34 POAG and 21 normal eyes were studied. VAD, VSD, and VCI were reduced in POAG versus normal (0.463 vs. 0.486, P=0.00029; 0.230 vs. 0.219, P=0.0014; 1.15 vs. 1.09, P=0.0044, respectively), with a trend of worsening with increased POAG severity. Reduced global VF MD was associated with reduced VAD and VCI, controlling for age and intereye correlation (P=0.0060, 0.0080; R=0.205, 0.211). Both superior and inferior hemifield MD were associated with corresponding VAD, VSD, and VCI (all P<0.007; R ranged from 0.12 to 0.29). Global GCIPL thickness was not associated with global OCTA parameters, and only inferior sector GCIPL thickness was associated with corresponding VAD, VSD, and VCI (P<0.05; R ranged from 0.15 to 0.16). Area under curves for VAD, VSD, and VCI were fair to good (0.83, 0.79, 0.82; respectively; P<0.0001).

Conclusions: Glaucomatous eyes had reduced GCIPL microcirculation. OCTA parameters had stronger associations with functional rather than structural measures of glaucoma. This observation deserves further study.

Citing Articles

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References

An L, Qin J, Wang R . Ultrahigh sensitive optical microangiography for in vivo imaging of microcirculations within human skin tissue beds. Opt Express. 2010; 18(8):8220-8. PMC: 2898895. DOI: 10.1364/OE.18.008220. View

Kuerten D, Fuest M, Koch E, Remky A, Plange N . Long term effect of trabeculectomy on retrobulbar haemodynamics in glaucoma. Ophthalmic Physiol Opt. 2014; 35(2):194-200. DOI: 10.1111/opo.12188. View

Takusagawa H, Liu L, Ma K, Jia Y, Gao S, Zhang M . Projection-Resolved Optical Coherence Tomography Angiography of Macular Retinal Circulation in Glaucoma. Ophthalmology. 2017; 124(11):1589-1599. PMC: 5651191. DOI: 10.1016/j.ophtha.2017.06.002. View

Chen C, Bojikian K, Gupta D, Wen J, Zhang Q, Xin C . Optic nerve head perfusion in normal eyes and eyes with glaucoma using optical coherence tomography-based microangiography. Quant Imaging Med Surg. 2016; 6(2):125-33. PMC: 4858460. DOI: 10.21037/qims.2016.03.05. View

Bojikian K, Chen C, Wen J, Zhang Q, Xin C, Gupta D . Optic Disc Perfusion in Primary Open Angle and Normal Tension Glaucoma Eyes Using Optical Coherence Tomography-Based Microangiography. PLoS One. 2016; 11(5):e0154691. PMC: 4858256. DOI: 10.1371/journal.pone.0154691. View

Mammo Z, Heisler M, Balaratnasingam C, Lee S, Yu D, Mackenzie P . Quantitative Optical Coherence Tomography Angiography of Radial Peripapillary Capillaries in Glaucoma, Glaucoma Suspect, and Normal Eyes. Am J Ophthalmol. 2016; 170:41-49. DOI: 10.1016/j.ajo.2016.07.015. View

Wright T, Goharian I, Gardiner S, Sehi M, Greenfield D . Short-term enhancement of visual field sensitivity in glaucomatous eyes following surgical intraocular pressure reduction. Am J Ophthalmol. 2014; 159(2):378-85.e1. DOI: 10.1016/j.ajo.2014.11.012. View

Rao H, Pradhan Z, Weinreb R, Reddy H, Riyazuddin M, Dasari S . 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. View

Campbell J, Zhang M, Hwang T, Bailey S, Wilson D, Jia Y . Detailed Vascular Anatomy of the Human Retina by Projection-Resolved Optical Coherence Tomography Angiography. Sci Rep. 2017; 7:42201. PMC: 5301488. DOI: 10.1038/srep42201. View

10.

Chen C, Bojikian K, Xin C, Wen J, Gupta D, Zhang Q . Repeatability and reproducibility of optic nerve head perfusion measurements using optical coherence tomography angiography. J Biomed Opt. 2016; 21(6):65002. PMC: 4896902. DOI: 10.1117/1.JBO.21.6.065002. View

11.

Jia Y, Wei E, Wang X, Zhang X, Morrison J, Parikh M . Optical coherence tomography angiography of optic disc perfusion in glaucoma. Ophthalmology. 2014; 121(7):1322-32. PMC: 4082728. DOI: 10.1016/j.ophtha.2014.01.021. View

12.

Flammer J . The vascular concept of glaucoma. Surv Ophthalmol. 1994; 38 Suppl:S3-6. DOI: 10.1016/0039-6257(94)90041-8. View

13.

Liu L, Jia Y, Takusagawa H, Pechauer A, Edmunds B, Lombardi L . Optical Coherence Tomography Angiography of the Peripapillary Retina in Glaucoma. JAMA Ophthalmol. 2015; 133(9):1045-52. PMC: 4950955. DOI: 10.1001/jamaophthalmol.2015.2225. View

14.

Yin X, Chao J, Wang R . User-guided segmentation for volumetric retinal optical coherence tomography images. J Biomed Opt. 2014; 19(8):086020. PMC: 4407675. DOI: 10.1117/1.JBO.19.8.086020. View

15.

Wang R, An L, Saunders S, Wilson D . Optical microangiography provides depth-resolved images of directional ocular blood perfusion in posterior eye segment. J Biomed Opt. 2010; 15(2):020502. PMC: 2852433. DOI: 10.1117/1.3353958. View

16.

Shin H, Park H, Jung K, Choi J, Park C . Glaucoma diagnostic ability of ganglion cell-inner plexiform layer thickness differs according to the location of visual field loss. Ophthalmology. 2013; 121(1):93-99. DOI: 10.1016/j.ophtha.2013.06.041. View

17.

Yarmohammadi A, Zangwill L, Diniz-Filho A, Suh M, Manalastas P, Fatehee N . Optical Coherence Tomography Angiography Vessel Density in Healthy, Glaucoma Suspect, and Glaucoma Eyes. Invest Ophthalmol Vis Sci. 2016; 57(9):OCT451-9. PMC: 4968912. DOI: 10.1167/iovs.15-18944. View

18.

Kim K, Park K, Jeoung J, Kim S, Kim D . Severity-dependent association between ganglion cell inner plexiform layer thickness and macular mean sensitivity in open-angle glaucoma. Acta Ophthalmol. 2014; 92(8):e650-6. DOI: 10.1111/aos.12438. View

19.

Zeimer R, Asrani S, Zou S, Quigley H, Jampel H . Quantitative detection of glaucomatous damage at the posterior pole by retinal thickness mapping. A pilot study. Ophthalmology. 1998; 105(2):224-31. DOI: 10.1016/s0161-6420(98)92743-9. View

20.

Weinreb R, Aung T, Medeiros F . The pathophysiology and treatment of glaucoma: a review. JAMA. 2014; 311(18):1901-11. PMC: 4523637. DOI: 10.1001/jama.2014.3192. View