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  • Title: Comparison of Peripapillary Choroidal Microvasculature Dropout in Primary Open-angle, Primary Angle-closure, and Pseudoexfoliation Glaucoma.
    Author: Jo YH, Sung KR, Shin JW.
    Journal: J Glaucoma; 2020 Dec; 29(12):1152-1157. PubMed ID: 32890109.
    Abstract:
    PRECIS: The prevalence of choroidal microvascular dropout (CMvD) was significantly higher in primary open-angle glaucoma (POAG) than primary angle-closure glaucoma (PACG) or pseudoexfoliation glaucoma (PXG) in the early stage. However, in the advanced stage, it did not differ among the 3 groups. PURPOSE: The purpose of this study was to compare the prevalence of peripapillary CMvD in POAG, PACG, and PXG. MATERIALS AND METHODS: The presence of peripapillary CMvD was identified using optical coherence tomography angiography (AngioVue/RTVue-XR) imaging of the choroid in 186 eyes from 186 subjects [age and visual field (VF) mean deviation (MD) matched; 62 POAG, 62 PACG, and 62 PXG eyes]. Prevalence of CMvD was compared among glaucoma types in early and moderate to advanced disease, as divided by VF MD (-6 dB). The association between glaucoma type and presence of CMvD was evaluated using logistic regression analysis. RESULTS: Prevalence of CMvD was significantly different between glaucoma types in early-stage disease (PACG 7.5%, PXG 25%, and POAG 46.3%, P<0.001), but it did not differ between glaucoma types in eyes with moderate to advanced disease (PACG 59.1%, PXG 68.2%, and POAG 81%; P=0.331). After adjusting for age, sex, the β-zone peripapillary atrophy/disc ratio, and glaucoma severity (VF MD), the CMvD odds ratio was 7.50 times greater in POAG than in PACG (P=0.001). CONCLUSIONS: CMvD was more common in POAG relative to both PACG and PXG, especially in early-stage disease. This finding suggested a role for ischemic injury in the pathogenesis of POAG.
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