Turkiye Klinikleri Journal of Ophthalmology

.: ORIGINAL RESEARCH
Oküler Hipertansiyonlu Gözlerde Foveal Avasküler Zon
Foveal Avascular Zone in Eyes with Ocular Hypertension
Arif Ülkü YENERa
aKeçiören Eğitim ve Araştırma Hastanesi, Göz Hastalıkları Kliniği, Ankara, TÜRKİYE
Turkiye Klinikleri J Ophthalmol. 2020;29(2):136-42
doi: 10.5336/ophthal.2019-71074
Article Language: TR
Full Text
ÖZET
 Amaç: Glokomda nöral ve korneal parametrelere ilave olarak bazı vasküler parametreler de etkilenir. Bu çalışmanın amacı, oküler hipertansiyonlu gözlerde vasküler yapıları ölçmek ve kıyaslamaktır. Gereç ve Yöntemler: Bir ya da 2 gözünde göz içi basıncı 21 mmHg'dan yüksek olan 19 hasta çalışmaya dâhil edildi. Hastalarda glokomatöz optik nöropati veya görme alanı kaybı bulunmuyordu. Hastaların 2 gözü ve kontrol kişilerin rastgele seçilen 1 gözünde yüzeysel ve derin foveal avasküler zon alanları, foveal ve parafoveal damar yoğunlukları ve koroid kalınlığı swept-source optikal koherens tomografi kullanılarak ölçüldü. Bulgular: Vasküler parametreler arasında, hastaların göz içi basıncı daha yüksek olan baskın gözlerinin derin foveal avasküler zon alanları kontrol grubu ile kıyaslandığında nispeten daha küçük olsa da bu farklılık istatistiksel olarak anlamlı değildi. Derin foveal avasküler zon alanı hastaların baskın olan gözlerinde 302,32±113,95 μm2, baskın olmayan diğer gözlerinde 317,16±109,89 μm2 olarak ölçülürken, bu parametre kontrol grubunu oluşturan kişilerde 414,33±215,72 μm2 idi. Bu parametre açısından baskın gözlerle kontrol gözleri ve baskın olmayan diğer gözlerle kontrol gözleri arasındaki istatistiksel fark sırasıyla p=0,065 ve p=0,10 düzeyinde idi. Yüzeysel foveal avasküler zon alanı, maküler damar yoğunluğu ve koroid kalınlığı gibi diğer vasküler parametreler de gruplar arasında farklı değildi. Sonuç: Bu çalışma, oküler hipertansiyonun makulada yüzeysel ve derin foveal avasküler zon alanlarını etkilemediğini göstermiştir.

Anahtar Kelimeler: Oküler hipertansiyon; foveal avasküler zon; damar yoğunluğu; koroid kalınlığı
ABSTRACT
 Objective: Certain vascular parameters are affected in glaucoma in addition to neural and corneal parameters. The aim of this study was to measure and compare vascular parameters in eyes with ocular hypertension. Material and Methods: Nineteen patients with intraocular pressure higher than 21 mmHg in one or both eyes were included in the study. Patients did not have glaucomatous optic neuropathy or visual field defect. Superficial and deep foveal avascular zone areas, foveal and parafoveal vessel densities and choroidal thickness in both eyes of patients and in a randomly selected eye of controls were measured by the swept-source optical coherence tomography. Results: Among the vascular parameters, although deep foveal avascular zone area of dominant eye with higher intraocular pressure of patients was relatively smaller compared to control group, this difference was not statistically significant. The deep foveal avascular zone area was 302.32±113.95 μm2 in dominant eyes of patients and 317.16±109.89 μm2 in non-dominant fellow eyes, while this parameter was 414.33±215.72 μm2 in the control group. The statistical difference between dominant eyes and control eyes and non-dominant fellow eyes and control eyes in terms of this parameter was p=0.065 and p=0.10, respectively. Other vascular parameters such as superficial foveal avascular zone area, macular vessel density and choroidal thickness did not differ between the groups. Conclusion: This study showed that ocular hypertension did not affect superficial and deep foveal avascular zone areas in macula.

Keywords: Ocular hypertension; foveal avascular zone; vessel density; choroidal thickness
REFERENCES:
  1. Weinreb RN, Aung T, Medeiros FA. The pathophysiology and treatment of glaucoma: a review. JAMA. 2014;311(18):1901-11. [Crossref]  [PubMed]  [PMC] 
  2. Weinreb RN, Khaw PT. Primary open-angle glaucoma. Lancet. 2004;363(9422):1711-20. [Crossref] 
  3. Harwerth RS, Wheat JL, Fredette MJ, Anderson DR. Linking structure and function in glaucoma. Prog Retin Eye Res. 2010;29(4):249-71. [Crossref]  [PubMed]  [PMC] 
  4. Medeiros FA, Vizzeri G, Zangwill LM, Alencar LM, Sample PA, Weinreb RN. Comparison of retinal nerve fiber layer and optic disc imaging for diagnosing glaucoma in patients suspected of having the disease. Ophthalmology. 2008;115(8):1340-6. [Crossref]  [PubMed]  [PMC] 
  5. Leung CK, Lam S, Weinreb RN, Liu S, Ye C, Liu L, et al. Retinal nerve fiber layer imaging with spectral-domain optical coherence tomography: analysis of the retinal nerve fiber layer map for glaucoma detection. Ophthalmology. 2010;117(9):1684-91. [Crossref]  [PubMed] 
  6. Garas A, Vargha P, Holló G. Diagnostic accuracy of nerve fiber layer, macular thickness and optic disc measurements made with the RTVue-100 optical coherence tomography to detect glaucoma]. Eye (Lond). 2011;25(1):57-65. [Crossref]  [PubMed]  [PMC] 
  7. Chen CL, Zhang A, Bojikian KD, Wen JC, Xhang Q, Xin C, et al. Peripapillary retinal nerve fiber layer vascular microcirculation in glaucoma using optical coherence tomography-based microangiography. Invest Ophthalmol Vis Sci. 2016;57(9):OCT475-85. [Crossref]  [PubMed]  [PMC] 
  8. Suh MH, Zangwill LM, Manalastas PI, Belghith A, Yarmohammadi A, Medeiros FA, et al. Deep retinal layer microvasculature dropout detected by the optical coherence tomography angiography in glaucoma. Ophthalmology. 2016;123(12):2509-18. [Crossref]  [PubMed]  [PMC] 
  9. Chen HS, Liu CH, Wu WC, Tseng HJ, Lee YS. Optical coherence tomography angiography of the superficial microvasculature in the macular and peripapillary areas in glaucomatous and healthy eyes. Invest Ophthalmol Vis Sci. 2017;58(9):3637-45. [Crossref]  [PubMed] 
  10. Dimitrova G, Chihara E, Takahashi H, Amano H, Okazaki K. Quantitative retinal optical coherence tomography angiography in patients with diabetes without diabetic retinopathy. Invest Ophthalmol Vis Sci. 2017;58(1):190-6. [Crossref]  [PubMed] 
  11. Chihara E, Dimitrova G, Amano H, Chihara T. Discriminatory power of superficial vessel density and prelaminar vascular flow index in eyes with glaucoma and ocular hypertension and normal eyes. Invest Ophthalmol Vis Sci. 2017;58(1):690-7. [Crossref]  [PubMed] 
  12. Akagi T, Iida Y, Nakanishi H, Terada N, Morooka S, Yamada H, et al. Microvascular density in glaucomatous eyes with hemifield visual field defects: an optical coherence tomography angiography study. Am J Ophthalmol. 2016;168:237-49. [Crossref]  [PubMed] 
  13. Yarmohammadi A, Zangwill LM, Diniz-Filho A, Saunders LJ, Suh MH, Wu Z, et al. Peripapillary and macular vessel density in patients with glaucoma and single-hemifield visual field defect. Ophthalmology. 2017;124(5):709-19. [Crossref]  [PubMed]  [PMC] 
  14. Coscas F, Sellam A, Glacet-Bernard A, Jung J, Goudot M, Miere A, et al. Normative data for vascular density in superficial and deep capillary plexuses of healthy adults assessed by optical coherence tomography angiography. Invest Ophthalmol Vis Sci. 2016;57(9):OCT211-23. [Crossref]  [PubMed] 
  15. Fujiwara A, Morizane Y, Hosokawa M, Kimura S, Shiode Y, Hirano M, et al. Factors affecting foveal avascular zone in healthy eyes: an examination using swept source optical coherence tomography angiography. PLoS One. 2017;12(11):e0188572. [Crossref]  [PubMed]  [PMC] 
  16. Sampson DM, Gong P, An D, Menghini M, Hansen A, Mackey DA, et al. Axial length variation impacts on superficial retinal vessel density and foveal avascular zone area measurements using optical coherence tomography angiography. Invest Ophthalmol Vis Sci. 2017;58(7):3065-72. [Crossref]  [PubMed] 
  17. Liu L, Jia Y, Takusagawa HL, Pechauer AD, Edmunds B, Lombardi L, et al. Optical coherence tomography angiography of the peripapillary retina in glaucoma. JAMA Ophthalmol. 2015;133(9):1045-52. [Crossref]  [PubMed]  [PMC] 
  18. Lisboa R, Paranhos A Jr, Weinreb RN, Zangwill LM, Leite MT, Medeiros FA. Comparison different spectral domain OCT scanning protocols for diagnosing preperimetric glaucoma. Invest Ophthalmol Vis Sci. 2013;54(5):3417-25. [Crossref]  [PubMed]  [PMC] 
  19. Yarmohammadi A, Zangwill LM, Diniz-Filho A, Suh MH, Manalastas PI, Fatehee N, et al. Optical coherence tomography angiography vessel density in healthy, glaucoma suspect and glaucoma. Invest Ophthalmol Vis Sci. 2016;57(9):OCT451-9. [Crossref]  [PubMed]  [PMC] 
  20. Gordon MO, Torri V, Miglior S, Beiser JA, Floriani I, Miller JP, et al; Ocular Hypertension Treatment Study Group, European Glaucoma Prevention Study Group. Validated prediction model for development of primary open-angle glaucoma in individuals with ocular hypertension. Ophthalmology. 2007;114(1):10-9. [Crossref]  [PubMed]  [PMC] 
  21. Medeiros FA, Weinreb RN, Zangwill LM, Alencar LM, Sample PA, Vasile C, et al. Long-term intraocular presure fluctuations and risk of conversion from ocular hypertension to glaucoma. Ophthalmology. 2008;115(6):934-40. [Crossref]  [PubMed]  [PMC] 
  22. Kwon J, Choi J, Shin JW, Lee J, Kook MS. Alterations of the foveal avascular zone measured by optical coherence tomography angiography in glaucoma patients with central visual field defects. Invest Ophthalmol Vis Sci. 2017;58(3):1637-45. [Crossref]  [PubMed] 
  23. Chao SC, Yang SJ, Chen HC, Sun CC, Liu CH, Lee CY. Early macular angiography among patients with glaucoma, ocular hypertension and normal subjects. J Ophthalmol. 2019;2019:7419470. [Crossref]  [PubMed]  [PMC] 

.: Up To Date

.: Process List

Login

 Forgot your password?

 New Registration  

Contact

Ortadoğu Reklam Tanıtım Yayıncılık Turizm Eğitim İnşaat Sanayi ve Ticaret A.Ş.

.: Address

Turkocagi Caddesi No:30 06520 Balgat / ANKARA
Phone: +90 312 286 56 56
Fax: +90 312 220 04 70
E-mail: info@turkiyeklinikleri.com

.: Manuscript Editing Department

Phone: +90 312 286 56 56/ 2
E-mail: yaziisleri@turkiyeklinikleri.com

.: English Language Redaction

Phone: +90 312 286 56 56/ 145
E-mail: tkyayindestek@turkiyeklinikleri.com

.: Marketing Sales-Project Department

Phone: +90 312 286 56 56/ 142
E-mail: reklam@turkiyeklinikleri.com

.: Subscription and Public Relations Department

Phone: +90 312 286 56 56/ 118
E-mail: abone@turkiyeklinikleri.com

.: Customer Services

Phone: +90 312 286 56 56/ 118
E-mail: satisdestek@turkiyeklinikleri.com

1. TERMS OF USE

1.1. To use the web pages with http://www.turkiyeklinikleri.com domain name or the websites reached through the sub domain names attached to the domain name (They will be collectively referred as "SITE"), please read the conditions below. If you do not accept these terms, please cease to use the "SITE." "SITE" owner reserves the right to change the information on the website, forms, contents, the "SITE," "SITE" terms of use anytime they want.

1.2. The owner of the "SITE" is Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. (From now on it is going to be referred as "Turkiye Klinikleri", shortly) and it resides at Turkocagi cad. No:30, 06520 Balgat Ankara. The services in the "SITE" are provided by "Turkiye Klinikleri."

1.3. Anyone accessing the "SITE" with or without a fee whether they are a natural person or a legal identity is considered to agree these terms of use. In this contract hereby, "Turkiye Klinikleri" may change the stated terms anytime. These changes will be published in the "SITE" periodically and they will be valid when they are published. Any natural person or legal identity benefiting from and reaching to the "SITE" are considered to be agreed to any change on hereby contract terms done by "Turkiye Klinikleri."

1.4. The "Terms of Use" hereby is published in the website with the last change on March 30th 2014 and the "SITE" is activated by enabling the access to everyone. The "Terms of Use" hereby is also a part of the any "USER Contract" was and/or will be done with the users using "Turkiye Klinikleri" services with or without a fee an inseparable.

2. DEFINITIONS

2.1. "SITE": A website offering different kind of services and context with a certain frame determined by "Turkiye Klinikleri" and it is accessible on-line on http://www.turkiyeklinikleri.com domain name and/or subdomains connected to the domain name.

2.2. USER: A natural person or a legal identity accessing to the "SITE" through online settings.

2.3. LINK: A link enabling to access to another website through the "SITE", the files, the context or through another website to the "SITE", the files and the context.

2.4. CONTEXT: Any visual, literary and auditory images published in the "Turkiye Klinikleri", "SITE" and/or any website or any accessible information, file, picture, number/figures, price, etc.

2.5. "USER CONTRACT": An electronically signed contract between a natural or a legal identity benefiting from special services "Turkiye Klinikleri" will provide and "Turkiye Klinikleri".

3. SCOPE OF THE SERVICES

3.1. "Turkiye Klinikleri" is completely free to determine the scope and quality of the services via the "SITE".

3.2. To benefit the services of "Turkiye Klinikleri" "SITE", the "USER" must deliver the features that will be specified by "Turkiye Klinikleri". "Turkiye Klinikleri" may change this necessity any time single-sided.

3.3. Not for a limited number, the services "Turkiye Klinikleri" will provide through the "SITE" for a certain price or for free are;

- Providing scientific articles, books and informative publications for health industry.

- Providing structural, statistical and editorial support to article preparation stage for scientific journals.

4. GENERAL PROVISIONS

4.1. "Turkiye Klinikleri" is completely free to determine which of the services and contents provided in the "SITE" will be charged.

4.2. People benefiting from the services provided by "Turkiye Klinikleri" and using the website can use the "SITE" only according to the law and only for personal reasons. Users have the criminal and civil liability for every process and action they take in the "SITE". Every USER agrees, declares and undertakes that they will not proceed by any function or action infringement of rights of "Turkiye Klinikleri"s and/or other third parties', they are the exclusive right holder on usage, processing, storage, made public and revealing any written, visual or auditory information reported to Turkiye Klinikleri" and/or "SITE" to the third parties. "USER" agrees and undertakes that s/he will not duplicate, copy, distribute, process, the pictures, text, visual and auditory images, video clips, files, databases, catalogs and lists within the "SITE", s/he will not be using these actions or with other ways to compete with "Turkiye Klinikleri", directly or indirectly.

4.3. The services provided and the context published within the "SITE" by third parties is not under the responsibility of "Turkiye Klinikleri", institutions collaborated with "Turkiye Klinikleri", "Turkiye Klinikleri" employee and directors, "Turkiye Klinikleri" authorized salespeople. Commitment to accuracy and legality of the published information, context, visual and auditory images provided by any third party are under the full responsibility of the third party. "Turkiye Klinikleri" does not promise and guarantee the safety, accuracy and legality of the services and context provided by a third party.

4.4. "USER"s cannot act against "Turkiye Klinikleri", other "USER"s and third parties by using the "SITE". "Turkiye Klinikleri" has no direct and/or indirect responsibility for any damage a third party suffered or will suffer regarding "USER"s actions on the "SITE" against the rules of the hereby "Terms of Use" and the law.

4.5. "USER"s accept and undertake that the information and context they provided to the "SITE" are accurate and legal. "Turkiye Klinikleri" is not liable and responsible for promising and guaranteeing the verification of the information and context transmitted to "Turkiye Klinikleri" by the "USER"s, or uploaded, changed and provided through the "SITE" by them and whether these information are safe, accurate and legal.

4.6. "USER"s agree and undertake that they will not perform any action leading to unfair competition, weakening the personal and commercial credit of "Turkiye Klinikleri" and a third party,  encroaching and attacking on personal rights within the "SITE" in accordance with the Turkish Commercial Code Law.

4.7. "Turkiye Klinikleri" reserves the right to change the services and the context within the "SITE"  anytime. "Turkiye Klinikleri" may use this right without any notification and timelessly. "USER"s have to make the changes and/or corrections "Turkiye Klinikleri" required immediately. Any changes and/or corrections that are required by "Turkiye Klinikleri", may be made by "Turkiye Klinikleri" when needed. Any harm, criminal and civil liability resulted or will result from changes and/or corrections required by "Turkiye Klinikleri" and were not made on time by the "USER"s belongs completely to the users.

4.8. "Turkiye Klinikleri" may give links through the "SITE" to other websites and/or "CONTEXT"s and/or folders that are outside of their control and owned and run by third parties. These links are provided for ease of reference only and do not hold qualification for support the respective web SITE or the admin or declaration or guarantee for the information inside. "Turkiye Klinikleri" does not hold any responsibility over the web-sites connected through the links on the "SITE", folders and context, the services or products on the websites provided through these links or their context.

4.9. "Turkiye Klinikleri" may use the information provided to them by the "USERS" through the "SITE" in line with the terms of the "PRIVACY POLICY" and "USER CONTRACT". It may process the information or classify and save them on a database. "Turkiye Klinikleri" may also use the USER's or visitor's identity, address, e-mail address, phone number, IP number, which sections of the "SITE" they visited, domain type, browser type, date and time information to provide statistical evaluation and customized services.

5. PROPRIETARY RIGHTS

5.1. The information accessed through this "SITE" or provided by the users legally and all the elements (including but not limited to design, text, image, html code and other codes) of the "SITE" (all of them will be called as studies tied to "Turkiye Klinikleri"s copyrights) belongs to "Turkiye Klinikleri". Users do not have the right to resell, process, share, distribute, display or give someone permission to access or to use the "Turkiye Klinikleri" services, "Turkiye Klinikleri" information and the products under copyright protection by "Turkiye Klinikleri". Within hereby "Terms of Use" unless explicitly permitted by "Turkiye Klinikleri" nobody can reproduce, process, distribute or produce or prepare any study from those under "Turkiye Klinikleri" copyright protection.

5.2. Within hereby "Terms of Use", "Turkiye Klinikleri" reserves the rights for "Turkiye Klinikleri" services, "Turkiye Klinikleri" information, the products associated with "Turkiye Klinikleri" copyrights, "Turkiye Klinikleri" trademarks, "Turkiye Klinikleri" trade looks or its all rights for other entity and information it has through this website unless it is explicitly authorized by "Turkiye Klinikleri".

6. CHANGES IN THE TERMS OF USE

"Turkiye Klinikleri" in its sole discretion may change the hereby "Terms of Use" anytime announcing within the "SITE". The changed terms of the hereby "Terms of Use" will become valid when they are announced. Hereby "Terms of Use" cannot be changed by unilateral declarations of users.

7. FORCE MAJEURE

"Turkiye Klinikleri" is not responsible for executing late or never of this hereby "Terms of Use", privacy policy and "USER Contract" in any situation legally taken into account as force majeure. Being late or failure of performance or non-defaulting of this and similar cases like this will not be the case from the viewpoint of "Turkiye Klinikleri", and "Turkiye Klinikleri" will not have any damage liability for these situations. "Force majeure" term will be regarded as outside of the concerned party's reasonable control and any situation that "Turkiye Klinikleri" cannot prevent even though it shows due diligence. Also, force majeure situations include but not limited to natural disasters, rebellion, war, strike, communication problems, infrastructure and internet failure, power cut and bad weather conditions.

8. LAW AND AUTHORISATION TO FOLLOW

Turkish Law will be applied in practicing, interpreting the hereby "Terms of Use" and managing the emerging legal relationships within this "Terms of Use" in case of finding element of foreignness, except for the rules of Turkish conflict of laws. Ankara Courts and Enforcement Offices are entitled in any controversy happened or may happen due to hereby contract.

9. CLOSING AND AGREEMENT

Hereby "Terms of Use" come into force when announced in the "SITE" by "Turkiye Klinikleri". The users are regarded to agree to hereby contract terms by using the "SITE". "Turkiye Klinikleri" may change the contract terms and the changes will be come into force by specifying the version number and the date of change on time it is published in the "SITE".

 

30.03.2014

Privacy Policy

We recommend you to read the terms of use below before you visit our website. In case you agree these terms, following our rules will be to your favor. Please read our Terms of Use thoroughly.

www.turkiyeklinikleri.com website belongs to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. and is designed in order to inform physicians in the field of health

www.turkiyeklinikleri.com cannot reach to user’s identity, address, service providers or other information. The users may send this information to the website through forms if they would like to. However, www.turkiyeklinikleri.com may collect your hardware and software information. The information consists of your IP address, browser type, operating system, domain name, access time, and related websites. www.turkiyeklinikleri.com cannot sell the provided user information (your name, e-mail address, home and work address, phone number) to the third parties, publish it publicly, or keep it in the website. Gathered information has a directing feature to be a source for the website’s visitor profile, reporting and promotion of the services.

www.turkiyeklinikleri.com uses the taken information:

-To enhance, improve and maintain the quality of the website

-To generate visitor’s profile and statistical data

-To determine the tendency of the visitors on using our website

-To send print publications/correspondences

-To send press releases or notifications through e-mail

-To generate a list for an event or competition

By using www.turkiyeklinikleri.com you are considered to agree that;

-Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. cannot be hold responsible for any user’s illegal and immoral behavior,

-Terms of use may change from time to time,

-It is not responsible for other websites’ contents it cannot control or the harms they may cause although it uses the connection they provided.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. may block the website to users in the following events:

-Information with wrong, incomplete, deceiving or immoral expressions is recorded to the website,

-Proclamation, advertisement, announcement, libelous expressions are used against natural person or legal identity,

-During various attacks to the website,

-Disruption of the website because of a virus.

Written, visual and audible materials of the website, including the code and the software are under protection by legal legislation.

Without the written consent of Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. the information on the website cannot be downloaded, changed, reproduced, copied, republished, posted or distributed.

All rights of the software and the design of the website belong to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. will be pleased to hear your comments about our terms of use. Please share the subjects you think may enrich our website or if there is any problem regarding our website.

info@turkiyeklinikleri.com