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Peripapillary capillary vessel density progression in advanced glaucoma: a case report.
1Department of Ophthalmology, Semmelweis University, Mária u. 39, Budapest, 1085, Hungary. hollo.gabor@med.semmelweis-univ.hu.
BMC Ophthalmology
|January 7, 2019
Summary
Peripapillary capillary vessel density (PcVD) progression indicates glaucoma worsening even when retinal nerve fiber layer thickness (RNFLT) and visual field tests show no change due to the floor effect.
Area of Science:
- Ophthalmology
- Glaucoma Research
- Optical Coherence Tomography (OCT) Imaging
Background:
- Juvenile open-angle glaucoma (JOAG) is a severe form of glaucoma requiring continuous monitoring.
- Assessing disease progression in advanced glaucoma can be challenging due to measurement limitations.
Observation:
- A case study of advanced JOAG in a 45-year-old female patient was prospectively followed for 2.5 years.
- Optical Coherence Tomography (OCT) was used to measure retinal nerve fiber layer thickness (RNFLT) and peripapillary capillary vessel density (PcVD).
- Visual field testing was conducted concurrently to assess functional deficits.
Findings:
- Peripapillary capillary vessel density (PcVD) in the inferior retina showed significant progression.
- Retinal nerve fiber layer thickness (RNFLT) and visual field cluster defects reached minimal detectable values, exhibiting a 'floor effect' with no measurable change.
- Progression was detected in PcVD ( -2.4%/year) while RNFLT showed minimal thinning (-0.5 μm/year) in the superior quadrant.
Implications:
- Peripapillary capillary vessel density (PcVD) can serve as a sensitive indicator of glaucomatous progression in advanced stages.
- PcVD monitoring may reveal disease advancement when RNFLT and visual field tests are limited by floor effects.
- This highlights the importance of utilizing multiple OCT-derived parameters for comprehensive glaucoma assessment.
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