The Role of Vessel Density as Measured by Optical Coherence Tomography Angiography in the Evaluation of Pseudoexfoliative Glaucoma: A Review of the Literature

Irini Chatziralli; Ilias Milionis; Aikaterini Christodoulou; Panagiotis Theodossiadis; George Kitsos

doi:10.1007/s40123-022-00483-1

The Role of Vessel Density as Measured by Optical Coherence Tomography Angiography in the Evaluation of Pseudoexfoliative Glaucoma: A Review of the Literature

Ophthalmol Ther. 2022 Apr;11(2):533-545. doi: 10.1007/s40123-022-00483-1. Epub 2022 Feb 24.

Authors

Irini Chatziralli¹, Ilias Milionis², Aikaterini Christodoulou², Panagiotis Theodossiadis³, George Kitsos²

Affiliations

¹ Second Department of Ophthalmology, National and Kapodistrian University of Athens, 1, Rimini Street, 12462, Haidari, Greece. eirchat@yahoo.gr.
² Department of Ophthalmology, University of Ioannina, Ioannina, Greece.
³ Second Department of Ophthalmology, National and Kapodistrian University of Athens, 1, Rimini Street, 12462, Haidari, Greece.

Abstract

Introduction: To review the existing literature about the optical coherence tomography angiography (OCTA) findings regarding peripapillary and macular vessel density (VD) in patients with pseudoexfoliative glaucoma (PXG).

Methods: A comprehensive search of the PubMed database was conducted to include articles up to November 1, 2021, using an appropriate search algorithm. The retrieved articles were assessed for eligibility and filtered manually to exclude duplicates, while articles and book chapters cited in the reference lists of the eligible articles obtained by this method were reviewed so as not to miss any relevant studies.

Results: There is consistency among the studies published so far that a significant decrease in peripapillary VD exists in eyes with PXG compared to controls, and macular VD has also been reported to be significantly lower in PXG eyes than controls. However, the existing literature remains controversial regarding OCTA findings in eyes with PXG compared to those with primary open-angle glaucoma (POAG). Several studies have found that peripapillary VD and macular VD were significantly lower in PXG than POAG, while other studies reported no significant difference.

Conclusions: Eyes with PXG were found to present decreased peripapillary and macular VD compared to control eyes, suggesting that a vascular component, including optic nerve hypoperfusion, may be implicated in the pathogenesis of PXG.

Keywords: Foveal Avascular Zone; Glaucoma; OCT Angiography; Peripapillary; Pseudoexfoliation; Vessel Density.

Publication types

Review