Pattern of peripapillary capillary density loss in ischemic optic neuropathy compared to that in primary open-angle glaucoma

Masoud Aghsaei Fard; Yanin Suwan; Sasan Moghimi; Lawrence S Geyman; Toco Y Chui; Richard B Rosen; Robert Ritch

doi:10.1371/journal.pone.0189237

Pattern of peripapillary capillary density loss in ischemic optic neuropathy compared to that in primary open-angle glaucoma

PLoS One. 2018 Jan 10;13(1):e0189237. doi: 10.1371/journal.pone.0189237. eCollection 2018.

Authors

Masoud Aghsaei Fard¹, Yanin Suwan^{2

3}, Sasan Moghimi¹, Lawrence S Geyman⁴, Toco Y Chui³, Richard B Rosen³, Robert Ritch³

Affiliations

¹ Farabi Eye Hospital, Tehran University of Medical Science, Tehran, Iran.
² Department of Ophthalmology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
³ Einhorn Clinical Research Center, New York Eye and Ear Infirmary of Mount Sinai, New York, NY, United States of America.
⁴ Icahn School of Medicine at Mount Sinai, New York, NY, United States of America.

Abstract

Purpose: Both non-arteritic anterior ischemic optic neuropathy (NAION) and primary open-angle glaucoma (POAG) damage retinal ganglion cell axons, which are perfused by the radial peripapillary capillaries. To evaluate the pattern of ischemia, we compared peripapillary capillary density (PCD) in NAION eyes to POAG eyes matched for visual field mean deviation and retinal nerve fiber layer thickness.

Methods: 31 chronic NAION (>6 months after the acute event) and unaffected fellow eyes (31 subjects), 42 moderate and severe POAG eyes (27 subjects), and 77 control eyes (46 healthy subjects) were imaged with a commercial optical coherence tomography angiography system (AngioVue, Avanti RTVue-XR, Optovue, CA) at two academic institutions. Two concentric circles of diameters 1.95mm (inner) and 3.45mm (outer) were manually placed on images centered on the optic nerve head, producing an annular region-of-interest. Image analysis with major vessel removal was performed using a custom program. Whole-image, whole-annulus, and sectoral PCDs were measured.

Results: Whole-image and whole-annulus PCDs in NAION and moderate and severe POAG eyes were significantly decreased compared to unaffected fellow eyes and control eyes (all P<0.001). Superior and temporal PCD values were affected more than other sectors in both NAION and POAG groups compared to control group. Whole-image and whole-annulus PCDs were not statistically different between NAION and POAG eyes (both P = 0.99). However, of all peripapillary sectors, the inferior sector PCD value was less affected in POAG eyes compared to NAION eyes (P = 0.001). Univariate analysis results also revealed a significant positive correlation between superior and inferior PCDs and corresponding RNFL thicknesses. The inferior sector correlation was greater in POAG than NAION eyes.

Conclusion: While the whole PCD values were not different in chronic NAION and POAG, the greater correlation of inferior PCD with corresponding RNFL sectors in POAG compared to NAION suggests greater susceptibility of the inferior radial peripapillary capillary in the pathogenesis of POAG.

Publication types

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

MeSH terms

Aged
Capillaries / pathology*
Case-Control Studies
Female
Glaucoma, Open-Angle / pathology*
Humans
Male
Middle Aged
Optic Neuropathy, Ischemic / pathology*
Tomography, Optical Coherence

Grants and funding

The Ablon Family Research Fund of New York Glaucoma Research Institute, New York, NY provided funding for this study. The sponsor or funding organization had no role in the design or conduct of this research.