Choroidal Structural and Vascular Changes in Early Primary Angle Closure Glaucoma

Area of Science:

• Ophthalmology
• Glaucoma Research
• Choroidal Imaging

Background:

• Primary angle-closure glaucoma (PACG) is a significant cause of vision loss.
• Understanding early pathological changes in PACG is crucial for timely intervention.
• Choroidal characteristics like thickness (CT) and vascularity index (CVI) are increasingly recognized as potential biomarkers in glaucoma.

Purpose of the Study:

• To investigate choroidal thickness (CT) and choroidal vascularity index (CVI) in early primary angle-closure glaucoma (PACG) using swept source optical coherence tomography angiography (SS-OCTA).

Main Methods:

• Compared CT and CVI in 86 early PACG patients and 79 healthy controls using SS-OCTA macular and optic disc scans.
• Analyzed 12x12 mm macular and 6x6 mm optic disc regions.
• Employed univariate and multivariate linear regression analyses to assess associations with age and axial length.

Main Results:

• Early PACG eyes showed significantly thicker CT and higher CVI across macular regions compared to healthy controls (P<0.05).
• Increased subfoveal CT and CVI were associated with younger age, PACG diagnosis, and shorter axial length.
• These differences in CT and CVI persisted even after adjusting for age and axial length (P<0.01).

Conclusions:

• Early PACG is associated with thicker choroidal thickness (CT) and higher choroidal vascularity index (CVI) in macular annular regions.
• These choroidal alterations are independent of age and axial length, suggesting a role in PACG pathogenesis.
• CVI may be a more sensitive indicator for monitoring disease progression in early PACG.