Abstract #91064 Published in IGR 21-4

Glaucoma-like Parapapillary Choroidal Microvasculature Dropout in Patients with Compressive Optic Neuropathy

Lee EJ; Kim JA; Kim TW; Kim H; Yang HK; Hwang JM
Ophthalmology 2020; 127: 1652-1662

PURPOSE: To characterize peripapillary choroidal microvasculature dropout (MvD) in patients with compressive optic neuropathy (CON) as compared with those with open-angle glaucoma (OAG) using OCT angiography (OCTA). DESIGN: Cross-sectional, observational study. PARTICIPANTS: Eighty-eight eyes of 44 patients with CON; 88 eyes of 88 patients with OAG matched by age, spherical error, and OCT-determined retinal nerve fiber layer thickness (RNFLT); and 88 eyes of 44 control participants matched by age and spherical error. METHODS: Peripapillary microvasculature was evaluated, and peripapillary vessel density was measured in en face images segmented into inner-retinal and choroidal layers using swept-source OCTA. An MvD was defined as a focal sectoral capillary dropout with no visible microvascular network in the choroidal layer. MAIN OUTCOME MEASURES: Comparative characteristics of MvD in eyes with CON and OAG. RESULTS: Microvasculature dropout was observed in 30 eyes (34.1%) of 22 patients (50.0%) with CON, and in 48 eyes of 48 patients (54.5%) with OAG (P = 0.011). All MvDs in the CON group were located in the temporal parapapillary sector, whereas MvDs in the OAG group were located in the temporal-inferior (n = 36) and temporal-superior (n = 4) sectors. At their locations, MvDs in the CON group were accompanied by significant reductions in retinal vessel density and RNFLT, but this was not observed in the OAG group. The presence of MvD was associated significantly with female gender (P = 0.020) and thinner global retinal nerve fiber layer (P = 0.006) in the CON group, but not in the OAG group. CONCLUSIONS: OCT angiography of the peripapillary area showed retinal and choroidal microvasculature impairment in patients with both CON and OAG. However, the features and associated characteristics of MvD differed between these groups, suggesting that the pathogenesis of peripapillary microvascular impairment may be diverse.

Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.

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10 Differential diagnosis e.g. anterior and posterior ischemic optic neuropathy
2.12 Choroid, peripapillary choroid, peripapillary atrophy (Part of: 2 Anatomical structures in glaucoma)

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