Optical Microangiography and Progressive Ganglion Cell-Inner Plexiform Layer Loss in Primary Open-Angle Glaucoma

Area of Science:

• Ophthalmology
• Glaucoma Research
• Optical Imaging

Background:

• Primary open-angle glaucoma (POAG) is a leading cause of irreversible blindness.
• Progressive loss of retinal ganglion cells and their inner plexiform layer (GCIPL) is a hallmark of glaucoma.
• Accurate monitoring of GCIPL thinning is crucial for managing POAG progression.

Purpose of the Study:

• To investigate the association between optical microangiography (OMAG) derived measurements and the rate of GCIPL loss in patients with POAG.
• To determine if baseline peripapillary and macular perfusion and vessel density correlate with GCIPL thinning over time.

Main Methods:

• A prospective case series included 63 eyes from 38 POAG patients followed for at least 2 years.
• Optical coherence tomography (OCT) and OMAG imaging were performed at baseline.
• Linear mixed models were used to assess the impact of clinical and OMAG parameters on GCIPL thickness change rate.

Main Results:

• Lower baseline peripapillary perfusion density (PD) and vessel density (VD) were significantly associated with a faster rate of GCIPL loss.
• The average rate of sector GCIPL change was -0.97 ± 0.15 µm per year.
• Baseline OMAG measurements of peripapillary PD and VD showed a significant correlation with GCIPL thinning.

Conclusions:

• Reduced baseline peripapillary microvascular density, as measured by OMAG, is a significant predictor of accelerated GCIPL loss in patients with mild to moderate POAG.
• OMAG may serve as a valuable tool for assessing glaucoma progression risk.