Comparison of Peripapillary Choroidal Thickness Between Primary Open-angle Glaucoma, Normal Tension Glaucoma, and Normal Eyes: A Systematic Review and Meta-analysis

Bjorn Kaijun Betzler; Dayna Joy Yen Siat; Rupesh Agrawal; Syril Dorairaj; Bryan Chin Hou Ang

doi:10.1016/j.ogla.2024.02.008

Comparison of Peripapillary Choroidal Thickness Between Primary Open-angle Glaucoma, Normal Tension Glaucoma, and Normal Eyes: A Systematic Review and Meta-analysis

Ophthalmol Glaucoma. 2024 Feb 23:S2589-4196(24)00035-8. doi: 10.1016/j.ogla.2024.02.008. Online ahead of print.

Authors

Bjorn Kaijun Betzler¹, Dayna Joy Yen Siat², Rupesh Agrawal³, Syril Dorairaj⁴, Bryan Chin Hou Ang⁵

Affiliations

¹ Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Tan Tock Seng Hospital, National Healthcare Group, Singapore.
² Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
³ Department of Ophthalmology, Tan Tock Seng Hospital, National Healthcare Group Eye Institute, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore; Singapore Eye Research Institute, Singapore. Electronic address: rupeshttsh@gmail.com.
⁴ Department of Ophthalmology, Mayo Clinic Florida, Jacksonville, Florida.
⁵ Department of Ophthalmology, Tan Tock Seng Hospital, National Healthcare Group Eye Institute, Singapore; Department of Ophthalmology, Mayo Clinic Florida, Jacksonville, Florida; Department of Ophthalmology, Woodlands Health, National Healthcare Group Eye Institute, Singapore. Electronic address: drbryanang@gmail.com.

PMID: 38403265
DOI: 10.1016/j.ogla.2024.02.008

Abstract

Topic: To investigate differences in peripapillary choroidal thickness (PPCT) between primary open-angle glaucoma (POAG), normal tension glaucoma (NTG), and healthy eyes, additionally comparing differences between POAG and NTG eyes.

Clinical relevance: Peripapillary choroidal thickness is a well-established OCT parameter in eyes with glaucoma and other ocular pathologies. The relationship between PPCT and glaucoma, if better understood, may facilitate the development of PPCT as a potential diagnostic and monitoring metric for glaucoma. In particular, there has yet to be a synthesis that directly compares PPCT between POAG eyes and NTG eyes.

Methods: A comprehensive literature search was performed on PubMed, EMBASE, and Cochrane Library, identifying studies from inception to December 2022. We included studies that measured PPCT using OCT in POAG, NTG, and healthy eyes. Mean difference (MD) among groups was calculated. Statistical analysis was performed using R version 4.2.0. Risk of bias of included studies was assessed using the Newcastle Ottawa Scale (NOS).

Results: Eighteen studies were included in this meta-analysis, with a pooled total of 935 healthy control eyes, 446 NTG eyes, and 934 POAG eyes. There was a significant reduction of PPCT in POAG eyes compared with healthy eyes [MD = -16.32; 95% confidence interval (CI) (-27.55 to -5.09)]. Reduction in PPCT was also significant in NTG eyes compared with healthy eyes [MD = -34.96; 95% CI (-49.97 to -19.95)]. NTG eyes had significantly reduced PPCT compared with POAG eyes [MD = -26.64; 95% CI (-49.00 to -4.28)].

Conclusions: Glaucomatous eyes appear to have significantly reduced PPCT compared with normal healthy eyes. In addition, PPCT in NTG eyes appear significantly thinner compared with that in POAG eyes.

Financial disclosure(s): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

Keywords: Normal tension glaucoma; OCT; Peripapillary choroidal thickness; Primary open-angle glaucoma.

Publication types

Review