Optic nerve head diurnal vessel density variations in glaucoma and ocular hypertension measured by optical coherence tomography angiography

Graefes Arch Clin Exp Ophthalmol. 2020 Jun;258(6):1237-1251. doi: 10.1007/s00417-020-04635-6. Epub 2020 Mar 27.

Abstract

Background/aims: To evaluate diurnal variations in optic nerve head (ONH) vessel density assessed by optical coherence tomography angiography (OCT-A) in healthy subjects, ocular hypertension (OHT), and open-angle glaucoma (OAG) patients.

Methods: Forty subjects (OAG, 21; OHT, 6; healthy, 13) were assessed for vessel density percentage (VD%) and flow index in the ONH (NH VD%, NH index), and in the radial peripapillary capillary layer (RPC VD%, RPC index) at 9:00, 11:00, 14:00, 16:00, and 18:00 on a single day. Repeated measures ANOVAs were used to test for changes in the parameters measured at multiple time points.

Results: All OCT-A parameters analyzed at the different time points were statistically lower in the OAG patients compared to both the OHT and healthy groups (p < 0.05). In the OAG group, the NH index, RPC index, NH VD%, and RPC VD% were statistically lower at 18:00 compared to 14:00, and the RPC VD% was statistically lower at 9:00 than 14:00. In the OHT group, the RPC index was statistically lower at 9:00 than 11:00. In the healthy group, the NH VD% and RPC VD% were statistically lower at 16:00 than 18:00, and the RPC index was statistically lower at 9:00 than 11:00. No other statistically significant difference was found in none of the three groups comparing any other time point (p > 0.05).

Conclusion: In healthy subjects, OHT and OAG patients, the variations in the OCT-A derived parameters were relatively small. These results suggest that in the clinical practice the OCT-A assessment can be performed independently of the time of the day, contrasting IOP evaluation.

Keywords: Glaucoma; Imaging; Optic nerve.

MeSH terms

  • Adult
  • Aged
  • Circadian Rhythm / physiology*
  • Female
  • Fluorescein Angiography
  • Glaucoma, Open-Angle / diagnosis
  • Glaucoma, Open-Angle / physiopathology*
  • Humans
  • Intraocular Pressure / physiology
  • Male
  • Middle Aged
  • Nerve Fibers / pathology
  • Ocular Hypertension / diagnosis
  • Ocular Hypertension / physiopathology
  • Optic Disk / blood supply*
  • Retinal Ganglion Cells / pathology
  • Retinal Vessels / physiopathology*
  • Tomography, Optical Coherence
  • Tonometry, Ocular
  • Visual Fields