Doing This Can Help Evaluate Glaucoma Progression Risk

Lower baseline macular and optic nerve head (ONH) vessel density are linked with a faster rate of retinal nerve fiber layer progression in patients with mild to moderate glaucoma, according to a prospective, observational study involving 83 individuals. 

Investigators measured macular whole image vessel density (m-wiVD) and optic nerve head whole image vessel density (onh-wiVD) in 132 eyes of the participants. They also obtained RNFL, minimum rim width (MRW), and ganglion cell plus inner plexiform layer (GCIPL) thickness. Researchers then looked at the how m-wiVD and onh-wiVD impacted RNFL rates over an average of ~27 months. Among the results: 

• Average baseline RNFL thickness was ~80μm; it declined an average of –1.07 μm/year.
• In univariate analysis, each 1% reduction of m-wiVD was linked with a 0.11-μm/year faster rate of RFNL decline.
• Each 1% reduction of onh-wiVD was linked with a 0.06-μm/year faster rate of RFNL decline.
• Multivariate analysis revealed the same relationships.
• The link between vessel density measurements RNFL loss rate was weak.  
• Average central corneal thickness also predicted faster RNFL decline. 

The authors concluded that assessing ONH and macular vessel density can help evaluate glaucoma progression risk and predict rates at which the disease will worsen. 

Moghimi S, Zangwill L, Penteado R, et al.  Macular and optic nerve head vessel density and progressive retinal nerve fiber layer loss in glaucoma. Ophthalmology. 2018;125(11):1720-1728. doi: https://doi.org/10.1016/j.ophtha.2018.05.006.