Choroidal Microvasculature Dropout in the Absence of Parapapillary Atrophy in POAG

초록

PURPOSE. To describe the parapapillary choroidal microvasculature dropout (CMvD) in glaucomatous eyes without beta-zone parapapillary atrophy (beta-PPA) and compare its char-acteristics with that of CMvD with beta-PPA.METHODS. Peripapillary choroidal microvasculature was evaluated on en face images obtained using optical coherence tomography angiography. CMvD was defined as a focal sectoral capillary dropout with no visible microvascular network identified in the choroidal layer. Peripapillary and optic nerve head structures, including the presence of beta-PPA, peripapillary choroidal thickness and lamina cribrosa curvature index were evaluated using the images obtained by enhanced depth-imaging optical coherence tomography.RESULTS. The study included 100 glaucomatous eyes with CMvD (25 without and 75 with beta-PPA) and 97 eyes without CMvD (57 without and 40 with beta-PPA). Regardless of the presence of beta-PPA, eyes with CMvD tended to have a worse visual field at a given RNFL thickness than eyes without CMvD, with patients having eyes with CMvD having lower diastolic blood pressure and more frequent cold extremities than patients with eyes lacking CMvD. Peripapillary choroidal thickness was significantly smaller in eyes with than without CMvD, but was not affected by the presence of beta-PPA. beta-PPA without CMvD was not associated with vascular variables.CONCLUSIONS. CMvD were found in the absence of beta-PPA in glaucomatous eyes. CMvDs had similar characteristics in the presence and absence of beta-PPA. Clinical and optic nerve head structural characteristics potentially relevant to compromised optic nerve head perfusion were dependent on the presence of CMvD, rather than the presence of beta-PPA.

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