Microvasculature Dropout and Development of Normal Tension Glaucoma in Glaucoma Suspects: The Normal Tension Glaucoma Suspect Cohort Study

Younhea Jung; Hae-Young Lopilly Park; Heejong Shin; Si Eun Oh; Seong Ah Kim; Ji-Young Lee; Da Young Shin; Soo Ji Jeon; Yong-Chan Kim; Hye-Young Shin; Jin A Choi; Na Young Lee; Chan Kee Park

doi:10.1016/j.ajo.2022.07.020

Microvasculature Dropout and Development of Normal Tension Glaucoma in Glaucoma Suspects: The Normal Tension Glaucoma Suspect Cohort Study

Am J Ophthalmol. 2022 Nov:243:135-148. doi: 10.1016/j.ajo.2022.07.020. Epub 2022 Aug 4.

Authors

Affiliations

¹ Department of Ophthalmology (Y.J., H-Y.L.P., H.S., S.E.O., S.A.K., J-Y.L., D.Y.S., S.J.J., Y-C.K., H-Y.S., J.A.C., N.Y.L., C.K.P.), The Catholic University of Korea, Seoul, Republic of Korea; Yeouido St. Mary's Hospital (Y.J.), Seoul, Republic of Korea.
² Department of Ophthalmology (Y.J., H-Y.L.P., H.S., S.E.O., S.A.K., J-Y.L., D.Y.S., S.J.J., Y-C.K., H-Y.S., J.A.C., N.Y.L., C.K.P.), The Catholic University of Korea, Seoul, Republic of Korea; Seoul St. Mary's Hospital (H-Y.P., H.S., S.E.O., S.A.K., C.K.P.), Seoul, Republic of Korea. Electronic address: lopilly@catholic.ac.kr.
³ Department of Ophthalmology (Y.J., H-Y.L.P., H.S., S.E.O., S.A.K., J-Y.L., D.Y.S., S.J.J., Y-C.K., H-Y.S., J.A.C., N.Y.L., C.K.P.), The Catholic University of Korea, Seoul, Republic of Korea; Seoul St. Mary's Hospital (H-Y.P., H.S., S.E.O., S.A.K., C.K.P.), Seoul, Republic of Korea.
⁴ Department of Ophthalmology (Y.J., H-Y.L.P., H.S., S.E.O., S.A.K., J-Y.L., D.Y.S., S.J.J., Y-C.K., H-Y.S., J.A.C., N.Y.L., C.K.P.), The Catholic University of Korea, Seoul, Republic of Korea; Daejeon St. Mary's Hospital (J-Y.L.), Daejeon, Republic of Korea.
⁵ Department of Ophthalmology (Y.J., H-Y.L.P., H.S., S.E.O., S.A.K., J-Y.L., D.Y.S., S.J.J., Y-C.K., H-Y.S., J.A.C., N.Y.L., C.K.P.), The Catholic University of Korea, Seoul, Republic of Korea; Eunpyeong St. Mary's Hospital (D.Y.S., N.Y.L.), Seoul, Republic of Korea.
⁶ Department of Ophthalmology (Y.J., H-Y.L.P., H.S., S.E.O., S.A.K., J-Y.L., D.Y.S., S.J.J., Y-C.K., H-Y.S., J.A.C., N.Y.L., C.K.P.), The Catholic University of Korea, Seoul, Republic of Korea; Incheon St. Mary's Hospital (S.J.J.), Incheon, Republic of Korea.
⁷ Department of Ophthalmology (Y.J., H-Y.L.P., H.S., S.E.O., S.A.K., J-Y.L., D.Y.S., S.J.J., Y-C.K., H-Y.S., J.A.C., N.Y.L., C.K.P.), The Catholic University of Korea, Seoul, Republic of Korea; Bucheon St. Mary's Hospital (Y-C.K.), Bucheon, Republic of Korea.
⁸ Department of Ophthalmology (Y.J., H-Y.L.P., H.S., S.E.O., S.A.K., J-Y.L., D.Y.S., S.J.J., Y-C.K., H-Y.S., J.A.C., N.Y.L., C.K.P.), The Catholic University of Korea, Seoul, Republic of Korea; Uijeongbu St. Mary's Hospital (H-Y.S.), Uijeongbu, Republic of Korea.
⁹ Department of Ophthalmology (Y.J., H-Y.L.P., H.S., S.E.O., S.A.K., J-Y.L., D.Y.S., S.J.J., Y-C.K., H-Y.S., J.A.C., N.Y.L., C.K.P.), The Catholic University of Korea, Seoul, Republic of Korea; St. Vincent's Hospital (J.A.C.), Suwon, Republic of Korea.

PMID: 35932818
DOI: 10.1016/j.ajo.2022.07.020

Abstract

Purpose: To investigate the contribution of vessel parameters to identify normal tension glaucoma (NTG) suspects at risk of NTG development.

Design: Multicenter prospective cohort study.

Subjects: A total of 307 eyes of 307 NTG suspects having intraocular pressure within the normal range; a suspicious optic disc, but without definite localized retinal nerve fiber layer (RNFL) defects; and a normal visual field (VF).

Methods: To measure laminar vessel density (VD), the VD was measured in the intradisc region from images of the deep vascular layers of optical coherence tomography angiography (OCT-A). Conversion to NTG was defined either by a new localized RNFL defect in the superotemporal or inferotemporal region, or the presence of a glaucomatous VF defect on 2 consecutive tests according to the pattern deviation plots.

Main outcome measure: Conversion to NTG.

Results: In total, 73 (23.8%) of the 307 NTG suspects converted to NTG during the follow-up period of 59.84 ± 12.44 months. Detection rate of microvasculature dropout (MvD) was significantly higher in NTG suspects who progressed to NTG (50.7%) than in those who did not (6.4%; P < .001). The macular deep VD (P = .006) and laminar deep VD (P = .004) were significantly lower in NTG suspects who progressed to NTG. The presence of MvD (P < .001) and lower laminar deep VD (P = .006) were significantly associated with NTG conversion.

Conclusions: NTG suspects with baseline MvD or a lower laminar deep VD on OCT-A had a higher risk of conversion.

Publication types

Multicenter Study
Research Support, Non-U.S. Gov't

MeSH terms

Cohort Studies
Humans
Intraocular Pressure
Low Tension Glaucoma* / diagnosis
Microvessels
Ocular Hypertension*
Prospective Studies
Tomography, Optical Coherence / methods
Visual Fields