We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Rate of Initial Optic Nerve Head Capillary Density Loss and Risk of Visual Field Progression.
- Authors
Tansuebchueasai, Natchada; Nishida, Takashi; Moghimi, Sasan; Wu, Jo-Hsuan; Mahmoudinezhad, Golnoush; Gunasegaran, Gopikasree; Kamalipour, Alireza; Zangwill, Linda M.; Weinreb, Robert N.
- Abstract
Key Points: Question: Are initial optic nerve head capillary density changes from optical coherence tomography angiography associated with visual field progression in patients with glaucoma and glaucoma suspect? Findings: In this cohort of 167 eyes in 109 patients, faster initial capillary density loss was associated with more rapid rates of visual field progression, including a doubling of the risk of developing event progression. Meaning: These findings suggest that monitoring of changes in optic nerve head capillary density provides complementary information to optical coherence tomography for assessing the risk of glaucoma progression. This cohort study evaluates the association between optic nerve head capillary density loss and visual field progression. Importance: Rapid initial optic nerve head capillary density loss may be used to assess the risk of glaucoma visual field progression. Objective: To investigate the association between the rate of initial optic nerve head capillary density loss from optical coherence tomography angiography (OCTA) and visual field progression. Design, Setting, Participants: This was a retrospective study of a longitudinal cohort at a glaucoma referral center. A total of 167 eyes (96 with primary open-angle glaucoma and 71 with glaucoma suspect) of 109 patients were monitored for a mean (SD) of 5.7 (1.4) years from January 2015 to December 2022. Data analysis was undertaken in April 2023. Main Outcomes and Measures: The rates of initial capillary density and average retinal nerve fiber layer loss were calculated from the first 3 optic nerve head OCTA and OCT scans, respectively, during the initial follow-up (mean [SD], 2.0 [1.0] years). Based on the median rate, eyes were categorized into fast and slow progressor groups. The association between initial capillary density change or retinal nerve fiber layer thinning and visual field progression was evaluated using linear-mixed and time-varying Cox models. Results: A total of 167 eyes of 109 patients (mean [SD] age, 69.0 [11.1] years; 56 [51.4%] female and 53 [48.6%] male) were assessed. Eighty-three eyes were slow OCTA progressors, while 84 eyes were fast with mean capillary density loss of −0.45% per year and −1.17% per year, respectively (mean difference, −0.72%/year; 95% CI,−0.84 to −0.60; P <.001). Similarly, 83 eyes were slow OCT progressors, while 84 eyes were fast with mean retinal nerve fiber layer thinning of −0.09 μm per year and −0.60 μm per year, respectively (mean difference, −0.51 μm/year; 95% CI,−0.59 to −0.43; P <.001). The fast OCTA and OCT progressors were associated with more rapid visual field loss (mean difference, −0.18 dB/year; 95% CI,−0.30 to −0.06; P =.004 and −0.17 dB/year; 95% CI,−0.29 to −0.06; P =.002, respectively). Fast OCTA progressing eyes were more likely to have visual field progression (hazard ratio, 1.96; 95% CI, 1.04-3.69; P =.04). Seventeen of 52 eyes (32.7%; 95% CI, 32.5-32.8) with fast OCTA and OCT progression developed subsequent visual field likely progression. Conclusion and Relevance: Rapid initial optic nerve head capillary density loss from OCTA was associated with a faster rate of visual field progression and a doubling of the risk of developing event progression in this study. These findings may support clinical use of OCTA and OCT optic nerve head measurements for risk assessment of glaucoma progression.
- Publication
JAMA Ophthalmology, 2024, Vol 142, Issue 6, p530
- ISSN
2168-6165
- Publication type
Article
- DOI
10.1001/jamaophthalmol.2024.0906