The evidence of early macula disturbance in glaucoma
Journal of Clinical and Experimental Ophthalmology

Journal of Clinical and Experimental Ophthalmology
Open Access

ISSN: 2155-9570

The evidence of early macula disturbance in glaucoma

9th Global Ophthalmology Summit

March 15-16, 2017 London, UK

Kurysheva N I, Maslova E V and Trubilina A V

Ophthalmological Center of the Federal Medical and Biological Agency, Russia

Posters & Accepted Abstracts: J Clin Exp Ophthalmol

Abstract :

Purpose: To assess the vascular density in fovea and parafovea and ganglion cells function in early stage of open angle glaucoma. Methods: Forty-eight eyes with POAG and 47 eyes of age-matched normal subjects were enrolled. The microcirculation parameter (Angio Flow Density, AFD) were measured using SD-OCT with AngioVue function (OCT-A). AFD retina was measured in the macula i.e., in the foveal area (circumference with a diameter of 1 mm) and parafovea (between the foveal border and a circumference 3 mm in diameter). The fovea and parafovea averaged value i.e., AFD Retina Whole En Face was measured. Retrobulbar vessels grayscale ultrasound, color Doppler image flow was studied using CDI. The electrophysiological study, including VEP in the reversal pattern and RERG was made using Tomey EP-1000. Results: All OCT-A, CDI and EPS indicators were reduced in glaucoma compared to healthy eyes. The following variables had the largest AUC and diagnostic value (z-value) to discriminate the early glaucoma from normal eyes: PERG P50 (mV) (z=4.35, p<0.0001; AUC 0.93 (0.853-1.0), PERG N95 (mV) (z=3.981, p<0.0001; AUC 0.893 (0.796-0.99), PERG Flicker 0.75 P1 (mV) (z=3.896, p<0.0001; AUC 0.915 (0.829-1.0), AFD Retina Superficial Whole En Face (z=3.83, p<0.0001; AUC 0.8 (0.69-0.90), VEP pattern P100 1?º (mV) (z=3.57, p<0.0001; AUC 0.84 (0.72-0.96), AFD Retina Deep Whole En Face (z=3.31, p=0.0007; AUC 0.76 (0.64-0.88), peripapillary vessel density (z=3.2, p=0.001; AUC 0.75 (0.63-0.87), end-diastolic flow velocity in ophthalmic artery (z=3.03, p=0.002; AUC 0.74 (0.61-0.86) and in TPCA (z=2.78, p=0.005; AUC 0.72 (0.58-0.86). Conclusions: The present study supported the theory of early involvement of macula in glaucoma process and revealed the priority of the parameters of the macular microcirculation in the early glaucoma detection over structural changes. The combination of OCT-A with Pattern ERG and VEP is very perspective for early glaucoma diagnostics.