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Published on: February 18, 2022
Peripapillary Vascular Density in Childhood Glaucoma: A Pilot Comparative Study with Age and Sex Matched Healthy
Flora Xydaki1, Paula Arribas-Pardo2, Barbara Burgos-Blasco1,3
1Department of Inmunology, Opthalmology and ORLIIORC, Complutense University of Madrid, 28040 Madrid, Spain.
Insights
Childhood glaucoma (CG) shows lower peripapillary vessel density and flux index compared to healthy eyes. While these indices correlate with RNFL thickness, they are less effective for diagnosis than RNFL measurements alone.
Area of Science:
- Ophthalmology
- Medical Imaging
- Glaucoma Research
Background:
- Childhood glaucoma (CG) is a severe form of glaucoma requiring early diagnosis.
- Assessing microvascular changes in CG is crucial for understanding disease progression.
Purpose of the Study:
- To evaluate peripapillary vessel indices, including peripapillary vessel density (PVD) and flux index (FI), in children with glaucoma.
- To compare these indices with retinal nerve fiber layer (RNFL) thickness measurements in CG patients and healthy controls.
Main Methods:
- A prospective, observational, cross-sectional study included 39 patients with CG and 50 healthy subjects.
- Optical coherence tomography (OCT) and OCT angiography (OCT-A) were used to measure RNFL thickness, PVD, and FI.
- Data were analyzed to compare measurements between CG and control groups.
Main Results:
- Patients with CG exhibited significantly lower peripapillary RNFL thickness, PVD, and FI compared to healthy subjects.
- Mean PVD was 0.52 ± 0.043% in CG versus 0.55 ± 0.014% in controls (p < 0.0001).
- Mean FI was 0.32 ± 0.054 in CG versus 0.37 ± 0.028 in controls (p < 0.0001).
- RNFL thickness demonstrated a higher diagnostic ability (AUROC 0.797) than PVD (AUROC 0.664) for distinguishing CG from healthy eyes.
Conclusions:
- Peripapillary vessel density and flux index are reduced in childhood glaucoma and correlate with RNFL thickness.
- However, PVD and FI have lower diagnostic value than RNFL thickness for identifying CG.
- These findings suggest potential microvascular compromise in the pathogenesis of childhood glaucoma.
Purpose:
The aim of this study concerns the evaluation of peripapillary vessel indices in childhood glaucoma (CG) and healthy subjects.
Material And Methods:
In this prospective, unicenter, observational cross-sectional study, patients with CG and age and sex-matched healthy subjects were included. We compared retinal nerve fiber layer (RNFL) measurements in optical coherence tomography (OCT), peripapillary vessel density (PVD), and the flux index (FI) of the superficial vascular plexus from OCT angiography (OCT-A) between CG patients and control groups.
Results:
We included 39 patients (68 eyes) with CG and 50 (95 eyes) healthy subjects. The peripapillary RNFL thickness, vessel density, and flux index were significantly lower in the CG group than in the control group. The mean PVD of CG patients was 0.52 ± 0.043%, compared with 0.55 ± 0.014%, p < 0.0001 in healthy subjects. The mean FI was 0.32 ± 0.054 versus 0.37 ± 0.028, p < 0.0001, in CG patients and healthy subjects, respectively. PVD and FI in the superior, inferior, and temporal sectors were significantly lower in CG. The peripapillary RNFL thickness showed a higher area under the ROC curve (AUROC) for discriminating healthy and CG eyes and was significantly different than the PVD (0.797, 95%CI 0.726-0.869; p < 0.0001 vs. 0.664, 95%CI 0.574-0.752; p 0.00037), p 0.012.
Conclusions:
PVD and FI show lower values in CG and correlate with RNFL thickness measurement but have lower diagnostic ability than RNFL thickness measurement. Our results reveal possible differences in the pathogenesis of microvascular compromise in childhood glaucoma patients.
