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. 2022 Apr 1;140(4):319-326.
doi: 10.1001/jamaophthalmol.2021.6433.

Association of Initial Optical Coherence Tomography Angiography Vessel Density Loss With Faster Visual Field Loss in Glaucoma

Takashi Nishida  1 , Sasan Moghimi  1 , Jo-Hsuan Wu  1 , Aimee C Chang  1 , Alberto Diniz-Filho  2 , Alireza Kamalipour  1 , Linda M Zangwill  1 , Robert N Weinreb  1
Affiliations

Association of Initial Optical Coherence Tomography Angiography Vessel Density Loss With Faster Visual Field Loss in Glaucoma

Takashi Nishida et al. JAMA Ophthalmol. .

Abstract

Importance: Rapid vessel density loss during an initial follow-up period may be associated with the rates of visual field loss over time.

Objectives: To evaluate the association between the rate of vessel density loss during initial follow-up and the rate of visual field loss during an extended follow-up period in patients suspected of having glaucoma and patients with primary open-angle glaucoma.

Design, setting, and participants: This retrospective cohort study assessed 124 eyes (86 with primary open-angle glaucoma and 38 suspected of having glaucoma) of 82 patients who were followed up at a tertiary glaucoma center for a mean of 4.0 years (95% CI, 3.9-4.1 years) from January 1, 2015, to February 29, 2020. Data analysis for the current study was undertaken in March 2021.

Main outcomes and measures: The rate of vessel density loss was derived from macular whole-image vessel density values from 3 optical coherence tomography angiography scans early during the study. The rate of visual field loss was calculated from visual field mean deviation during the entire follow-up period after the first optical coherence tomography angiography visit. Linear mixed-effects models were used to estimate rates of change.

Results: A total of 124 eyes from 82 patients (mean [SD] age, 69.2 [10.9] years; 41 female [50.0%] and 41 male [50.0%]; and 20 African American [24.4%], 10 Asian [12.2%], 50 White [61.0%], and 2 other race or ethnicity [2.4%]) were assessed. The annual rate of vessel density change was -0.80% (95% CI, -0.88% to -0.72%) during a mean initial follow-up of 2.1 years (95% CI, 1.9-2.3 years). Eyes with annual rates of vessel density loss of -0.75% or greater (n = 62) were categorized as fast progressors, and eyes with annual rates of less than -0.75% (n = 62) were categorized as slow progressors. The annual rate of visual field loss was -0.15 dB (95% CI, -0.29 to -0.01 dB) for the slow optical coherence tomography angiography progressors and -0.43 dB (95% CI, -0.58 to -0.29 dB) for the fast optical coherence tomography angiography progressors (difference, -0.28 dB; 95% CI, -0.48 to -0.08 dB; P = .006). The fast optical coherence tomography angiography progressor group was associated with the faster overall rate of visual field loss in a multivariable model after adjusting to include concurrent visual field mean deviation rate (-0.17 dB; 95% CI, -0.33 to -0.01 dB; P = .04).

Conclusions and relevance: The findings of this cohort study suggest that faster vessel density loss during an initial follow-up period was associated with faster concurrent and subsequent rates of visual field loss during an extended period.

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Conflict of interest statement

Conflict of Interest Disclosures: Dr Zangwill reported receiving grants from Heidelberg Engineering, personal fees from AbbVie Inc, and research equipment from Heidelberg Engineering, Carl Zeiss Meditec, Topcon Inc, and research equipment from Optovue Inc outside the submitted work; in addition, Dr Zangwill had a licensed patent for Carl Zeiss Meditec. Dr Weinreb reported receiving nonfinancial support from Heidelberg Engineering, Carl Zeiss Meditec, Konan Medical, Optovue, Centervue, and Topcon; grants from National Eye Institute; and personal fees from Aerie Pharmaceuticals, Allergan, Equinox, Eyenovia, Nicox, and Topcon outside the submitted work. No other disclosures were reported.

Figures

Figure.
Figure.. Association of the Rate of Visual Field Mean Deviation (MD) Loss and the Rate of Vessel Density Loss and Ganglion Cell Complex Thinning
The r2 and P value represent the association after adjustment for age and mean intraocular pressure during follow-up.
See this image and copyright information in PMC

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References

    1. Weinreb RN, Leung CK, Crowston JG, et al. . Primary open-angle glaucoma. Nat Rev Dis Primers. 2016;2:16067. doi:10.1038/nrdp.2016.67 - DOI - PubMed
    1. Weinreb RN, Aung T, Medeiros FA. The pathophysiology and treatment of glaucoma: a review. JAMA. 2014;311(18):1901-1911. doi:10.1001/jama.2014.3192 - DOI - PMC - PubMed
    1. Shoji T, Zangwill LM, Akagi T, et al. . Progressive macula vessel density loss in primary open-angle glaucoma: a longitudinal study. Am J Ophthalmol. 2017;182:107-117. doi:10.1016/j.ajo.2017.07.011 - DOI - PMC - PubMed
    1. Moghimi S, Zangwill LM, Penteado RC, et al. . Macular and optic nerve head vessel density and progressive retinal nerve fiber layer loss in glaucoma. Ophthalmology. 2018;125(11):1720-1728. doi:10.1016/j.ophtha.2018.05.006 - DOI - PubMed
    1. WuDunn D, Takusagawa HL, Sit AJ, et al. . OCT angiography for the diagnosis of glaucoma: a report by the American Academy of Ophthalmology. Ophthalmology. 2021;128(8):1222-1235. doi:10.1016/j.ophtha.2020.12.027 - DOI - PubMed

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