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Macula Vessel Density and Thickness in Early Primary Open-Angle Glaucoma.

Huiyuan Hou1, Sasan Moghimi2, Linda M Zangwill1

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Ganglion cell complex (GCC) thinning and macula vessel density loss occur in early glaucoma. GCC loss is more pronounced than vessel density loss in early primary open-angle glaucoma (POAG), though both detect disease similarly.

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Area of Science:

  • Ophthalmology
  • Glaucoma research
  • Retinal imaging analysis

Background:

  • Primary open-angle glaucoma (POAG) is a leading cause of irreversible blindness.
  • Early detection of POAG is crucial for timely intervention and vision preservation.
  • Assessing structural and vascular changes in the retina can aid in early glaucoma diagnosis.

Purpose of the Study:

  • To compare ganglion cell complex (GCC) thickness and macula vessel density in preperimetric and early primary open-angle glaucoma (POAG) eyes.
  • To characterize the progression of GCC thinning and macula vessel density loss in early stages of POAG.
  • To evaluate the diagnostic utility of GCC thickness and macula vessel density for detecting early glaucoma.

Main Methods:

  • A cross-sectional study involving 57 healthy, 68 preperimetric POAG, and 162 early POAG eyes.
  • Simultaneous evaluation of GCC thickness using OCT and macula vessel density using OCT angiography (OCT-A).
  • Comparison of percent loss from normal for GCC thickness and macula vessel density, with diagnostic accuracy assessed by ROC curve analysis.

Main Results:

  • Both GCC thickness and macula vessel density were significantly reduced in preperimetric and early POAG eyes compared to healthy controls.
  • Early POAG eyes exhibited greater GCC thickness loss than preperimetric POAG eyes, while vessel density loss was similar between these groups.
  • In early POAG, GCC thickness loss was significantly greater than vessel density loss, whereas in preperimetric POAG, losses were comparable.
  • GCC thickness and macula vessel density demonstrated similar diagnostic accuracy in differentiating early glaucoma from healthy eyes.

Conclusions:

  • Both GCC thinning and macula vessel density reduction are detectable in preperimetric and early POAG.
  • GCC loss is more substantial than vessel density loss in early perimetric POAG.
  • Optical coherence tomography (OCT) and OCT angiography (OCT-A) show comparable efficacy in detecting early glaucoma.