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Abstract
Purpose To investigate the relationship of macular intercapillary area (ICA) with macular ganglion cell-inner plexiform layer (GCIPL) thickness and central visual field sensitivity (CVFS) in normal tension glaucoma (NTG).
Methods Seventy-eight early NTG eyes, 33 moderate-to-severe NTG eyes and 75 normal control eyes were cross-sectional evaluated. All participants underwent swept-source optical coherence tomography angiography (OCT-A; DRI-OCT, Topcon, Tokyo, Japan). A customised MATLAB program was used to quantify macular OCT-A metrics at central 3×3 mm macular region including vascular density (VD), foveal avascular zone (FAZ) area, 10 largest ICA including FAZ area (ICA10_IncFAZ) and excluding FAZ area (ICA10_ExcFAZ). Generalised estimating equation regression models were performed to determine the relationships of OCT-A vascular metrics with GCIPL thickness in the macular region and CVFS.
Results NTG eyes had lower global VD, larger ICA10_IncFAZ, and larger ICA10_ExcFAZ than normal controls (all p≤0.016). In the multivariable analyses, decreased VD (β=−0.304, p=0.006) and increased ICA (β=−0.231 for ICA10_IncFAZ and β=−0.259 for ICA10_ExcFAZ, all p≤0.042) were significantly associated with decreased GCIPL thickness in early NTG eyes but not in moderate-to-severe NTG eyes. ICA enlargement was associated with CVFS in early NTG eyes (β=−0.310, p=0.009), while VD was associated with CVFS in moderate-to-severe NTG eyes (β=−0.272, p=0.038).
Conclusion ICA enlargement could be a potentially important disease marker of early NTG as reflected by its association with GCIPL thinning and decrease CVFS specifically for early NTG eyes.
- glaucoma
- macula
- diagnostic tests/investigation
- field of vision
Data availability statement
All data relevant to the study are included in the article or uploaded as online supplemental information. The patients’ data are keep in the Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong. We follow the University and Department protocol to ensure the safety of the patients’ data.
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Data availability statement
All data relevant to the study are included in the article or uploaded as online supplemental information. The patients’ data are keep in the Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong. We follow the University and Department protocol to ensure the safety of the patients’ data.
Footnotes
RS and YMW are joint first authors.
CCT and PPC contributed equally.
Contributors RS, YMW and PPC contributed to study design, data collection, statistical analyses, writing up of the manuscript, and responses to reviewers’ comments. CYC provided technical support, study design and data collection. FYT and AL provided technical support for the MATLAB program and measurement of ICA. PPC also contributed to patients’ recruitment. PPC and CCT conceptualized, designed and coordinate the execution of this study. CCT is the guarantor of this manuscript.
Funding Health and Medical Research Fund, Hong Kong (05162836)
Disclaimer The funding organisation had no role in the design or conduct of this research.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.
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