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Factors associated with choroidal microvascular dropout change.

Eleonora Micheletti1, Sasan Moghimi1, Takashi Nishida1

  • 1Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA.

The British Journal of Ophthalmology
|July 8, 2022
PubMed
Summary

Worse visual field and higher intraocular pressure (IOP) fluctuations are linked to enlarged choroidal microvasculature dropout in glaucoma patients. Understanding these factors may help in managing glaucoma progression.

Keywords:
glaucoma

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Area of Science:

  • Ophthalmology
  • Glaucoma Research
  • Vascular Biology

Background:

  • Choroidal microvasculature dropout (MvD) is a potential indicator of glaucomatous damage.
  • Optical coherence tomography angiography (OCT-A) allows for the visualization and analysis of MvD.

Purpose of the Study:

  • To identify factors associated with the enlargement of MvD in eyes with glaucoma.
  • To investigate the relationship between ocular parameters and MvD progression.

Main Methods:

  • Ninety-one eyes from 68 primary open-angle glaucoma patients with at least 2 years of follow-up were analyzed.
  • OCT-A and OCT scans were used to measure MvD area and angular circumference.
  • Univariable and multivariable mixed effects models were employed to determine contributing factors.

Main Results:

  • Peripapillary MvD was detected in a majority of eyes (58.2%) at baseline.
  • Faster MvD enlargement was associated with worse baseline visual field mean deviation (MD), greater intraocular pressure (IOP) fluctuations, higher peak IOP, and more IOP-lowering medications.
  • Worse baseline VF MD and greater IOP fluctuation were significantly linked to faster circumferential MvD enlargement.

Conclusions:

  • Increased IOP fluctuations, higher peak IOP, poorer baseline visual field MD, and a greater number of glaucoma medications are significantly associated with MvD enlargement in glaucoma.
  • Identifying these factors can enhance the understanding of choroidal vasculature's role in glaucoma pathogenesis.