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An Ex Vivo Choroid Sprouting Assay of Ocular Microvascular Angiogenesis

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Choroidal Microvascular Dropout in Pseudoexfoliation Glaucoma.

Zia S Pradhan¹, Harsha L Rao^1,2, Shivani Dixit¹

¹Narayana Nethralaya, Rajajinagar, Bangalore, India.

Investigative Ophthalmology & Visual Science

|May 21, 2019

Summary

Choroidal microvasculature dropout (CMvD) is less common in pseudoexfoliation glaucoma (PXG) than in primary open-angle glaucoma (POAG). This finding suggests differences in glaucoma pathophysiology and vascular involvement between these conditions.

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Area of Science:

Ophthalmology
Glaucoma Research
Vascular Imaging

Background:

Pseudoexfoliation glaucoma (PXG) and primary open-angle glaucoma (POAG) are common forms of glaucoma.
Understanding the underlying pathophysiology, including vascular changes, is crucial for diagnosis and treatment.
Choroidal microvasculature dropout (CMvD) is a potential indicator of vascular compromise in glaucoma.

Purpose of the Study:

To compare the prevalence of choroidal microvasculature dropout (CMvD) between eyes with PXG and POAG.
To assess if CMvD differs in glaucoma patients with similar disease severity.

Main Methods:

A cross-sectional study included 39 PXG eyes and 39 age- and disease-severity-matched POAG eyes.
Optical coherence tomography angiography (OCTA) was used to evaluate CMvD on choroidal slabs.
Visual fields and optical coherence tomography (OCT) were performed to confirm glaucoma severity.

Main Results:

Groups had similar visual field mean deviation and peripapillary retinal nerve fiber layer thickness.
Prevalence of CMvD was significantly lower in PXG eyes (46.2%) compared to POAG eyes (79.5%), with P=0.002.
Multivariate analysis confirmed significantly lower odds of CMvD in PXG eyes (OR: 0.18-0.21, P < 0.01).

Conclusions:

The prevalence of CMvD is significantly lower in pseudoexfoliation glaucoma compared to primary open-angle glaucoma.
This suggests a potentially different role of vascular changes in the pathogenesis of PXG versus POAG.