Diurnal fluctuations of macular vessel density in patients with primary open-angle glaucoma and healthy subjects
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ORIGINAL PAPER
Diurnal fluctuations of macular vessel density in patients with primary open-angle glaucoma and healthy subjects Xiaojie Wang . Juanjuan Chen . Shaodan Zhang . Xiao Shang . Kun Zhou . Yuan Lan . Jianqiu Cai . Yuanbo Liang
Received: 19 December 2019 / Accepted: 28 April 2020 Ó Springer Nature B.V. 2020
Abstract Purpose To investigate the diurnal fluctuations of macular vessel density (VD) in primary open-angle glaucoma (POAG) and healthy subjects using optical coherence tomography angiography. Methods A total of 22 POAG eyes and 15 healthy eyes were included in this study. Macular VD, intraocular pressure, and blood pressure were repeatedly measured from 8 AM to 8 PM at a 2-h interval on a single day. Main outcome measures: the macular VD measurements, their diurnal fluctuations, including the difference between their maximal and minimal value (max–min) and their coefficient of variation (CV) in superficial capillary plexus (SCP) and deep capillary plexus (DCP). The mixed-effects model was performed to compare the fluctuations between groups. Results After adjusted age, the diurnal fluctuations of macular VD in SCP and DCP were significantly higher in POAG eyes compared with healthy subjects (max– min: 6.65 ± 3.54%, 3.92 ± 3.63%, respectively;
p = 0.037 and CV: 0.06 ± 0.03, 0.04 ± 0.03, respectively; p = 0.003). The fovea VD in DCP of POAG eyes was higher than in healthy subjects (31.52 ± 4.68% and 25.71 ± 3.70%, p = 0.009). However, there was no significant difference between the fovea VD in SCP in two groups (20.97 ± 4.75% and 19.29 ± 4.35%, p = 0.670). The diurnal macular superficial VD measured in most of the participants was lower in the morning. Conclusions Whether it is a max–min or a CV assessment method, the POAG eyes had more significant diurnal fluctuations of macular VD than healthy controls, suggesting impaired vascular autoregulation in POAG eyes. Keywords Diurnal fluctuations Macular vessel density Primary open-angle glaucoma Healthy subjects
Introduction X. Wang S. Zhang X. Shang K. Zhou Y. Lan Y. Liang (&) The Eye hospital of Wenzhou Medical University, Wenzhou Medical University, Wenzhou, Zhejiang, China e-mail: [email protected] J. Chen J. Cai The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou Medical University, Wenzhou, Zhejiang, China
Primary open-angle glaucoma (POAG) is characterized by progressive degeneration of the optic nerves and loss of retinal ganglion cells and their axons, resulting in structural damage to the optic nerve head and inner retina accompanied by irreversible visual field damage [1]. The pathogenic mechanisms leading to glaucomatous optic neuropathy remain controversial. In addition to elevated intraocular pressure (IOP) [2, 3], vascular
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Int Ophthalmol
dysregulation was proposed to have a potential role in the pathophysiology of glaucoma [4–6]. The recent development of optical coherence tomography angiography (OCTA) allowed noninvasive visualization of the r
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