Turkiye Klinikleri Journal of Ophthalmology

.: ORIGINAL RESEARCH
Evaluation of Choroidal and Retinal Vascular Alterations in Macular Region of Eyes with Exfoliation Glaucoma: A Cross-Sectional Study
Eksfoliasyon Glokomlu Gözlerde Makulada Koroidal ve Retinal Vasküler Değişikliklerin Değerlendirilmesi: Kesitsel Çalışma
Gözde HONDURa, Emine ŞENa, Mevlüt YILMAZa, Serdar BAYRAKTARa, Ufuk ELGİNa
aClinic of Ophthalmology, University of Health Sciences Ulucanlar Eye Training and Research Hospital, Ankara, Türkiye
Turkiye Klinikleri J Ophthalmol. 2022;31(2):55-61
doi: 10.5336/ophthal.2021-84780
Article Language: EN
Full Text
ABSTRACT
 Objective: To characterize the alterations in the vasculature of the retina and choroid in eyes with exfoliation glaucoma (XFG) with the enhanced depth imaging (EDI) modality of an optical coherence tomography (OCT) and OCT angiography (OCTA). Material and Methods: In this cross-sectional observational study, the choroidal vascularity index (CVI) values were assessed with EDI OCT and macula vessel density (VD) in the superficial capillary plexus (SCP) values were assessed with OCTA compared among 35 XFG cases (15 eyes with early stage and 20 eyes with moderate to advanced stage) and 32 healthy controls, which were age and sex matched. Results: The eyes with XFG had significantly lower global (whole image) macula VDs compared with the control eyes (p<0.001). The eyes with moderate to advanced stage XFG had also lower mean CVI values compared with the control eyes (p=0.01). The mean CVI values of the XFG eyes had a moderate correlation with the visual field MD values (r=0.398, p=0.01), while choroidal thickness values of the XFG eyes did not demonstrate such an association with the visual field MD values (r=0.035, p=0.84). Mean macula VD values in the SCP demonstrated a strong correlation with the visual field MD values (r=0.698, p<0.00001). Conclusion: The lower CVI and macula VD of XFG eyes compared with healthy controls and its significant correlation with the severity of glaucoma imply the role of retinal and choroidal vascularity in XFG pathogenesis.

Keywords: Choroidal vascularity index; enhanced depth imaging; optical coherence tomography angiography; vessel density
ÖZET
 Amaç: Bu çalışmanın amacı, eksfoliasyon glokomlu (EG) gözlerde retina ve koroid vaskülaritesindeki değişiklikleri, optik koherens tomografi (OKT) artırılmış derinlik görüntüleme (ADG) modu ve OKT anjiyografisi (OKTA) ile karakterize etmektir. Gereç ve Yöntemler: Bu kesitsel gözlemsel çalışmada, koroid vaskülarite indeksi (KVİ) ADG mod OKT ile ve makula yüzeyel kapiller pleksus (YKP) damar dansitesi (DD) OKTA ile değerlendirildi; EG vakaları (n=35, 15 erken evre göz ve 20 orta ileri evre göz) ile yaş-cinsiyet uyumlu sağlıklı kontrol grubu (n=32) arasında karşılaştırıldı. Bulgular: EG'li gözlerde, kontrol grubuna göre daha düşük global makula DD değerleri saptandı (p<0,001). Ayrıca orta ileri evre EG'li gözlerde, kontrol grubuna göre daha düşük ortalama KVİ değerleri saptandı (p=0,01). EG'li gözlerin ortalama KVİ değeri, görme alanı ortalama sapma değeri ile orta derecede korelasyon gösterirken (r=0,398, p=0,01); ortalama koroid kalınlığı değeri, görme alanı ortalama sapma değeri ile anlamlı korelasyon göstermedi (r=0,035, p=0,84). Makuladaki ortalama YKP DD değeri ise görme alanı ortalama sapma değeri ile güçlü bir korelasyon gösterdi (r=0,698, p<0,00001). Sonuç: Sağlıklı kontrollerle karşılaştırıldığında EG'li gözlerin düşük KVİ ve makula DD'sine sahip olması ve bunların glokomun şiddeti ile anlamlı derecede korele olması, EG patogenezinde retinal ve koroidal vaskülaritenin rolüne işaret etmektedir.

Anahtar Kelimeler: Koroid vaskülarite indeksi; artırılmış derinlik görüntüleme; optik koherens tomografi anjiyografi; damar dansitesi
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