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Rapid Vessel Density Loss tied with Faster Rate of Visual Field Loss: Study
Rapid vessel density loss tied to faster rate of visual field loss, according to a new study published in the JAMA Ophthalmology.
Rapid vessel density loss during an initial follow-up period may be associated with the rates of visual field loss over time.
A study was conducted to evaluate the association between the rate of vessel density loss during initial follow-up and the rate of visual field loss during an extended follow-up period in patients suspected of having glaucoma and patients with primary open-angle glaucoma.
This retrospective cohort study assessed 124 eyes (86 with primary open-angle glaucoma and 38 suspected of having glaucoma) of 82 patients who were followed up at a tertiary glaucoma center for a mean of 4.0 years (95% CI, 3.9-4.1 years) from January 1, 2015, to February 29, 2020. Data analysis for the current study was undertaken in March 2021.
The rate of vessel density loss was derived from macular whole-image vessel density values from 3 optical coherence tomography angiography scans early during the study. The rate of visual field loss was calculated from visual field mean deviation during the entire follow-up period after the first optical coherence tomography angiography visit. Linear mixed-effects models were used to estimate rates of change.
Results of the study are:
A total of 124 eyes from 82 patients (mean [SD] age, 69.2 [10.9] years; 41 female [50.0%] and 41 male [50.0%]; and 20 African American [24.4%], 10 Asian [12.2%], 50 White [61.0%], and 2 other race or ethnicity [2.4%]) were assessed. The annual rate of vessel density change was −0.80% (95% CI, −0.88% to −0.72%) during a mean initial follow-up of 2.1 years (95% CI, 1.9-2.3 years). Eyes with annual rates of vessel density loss of −0.75% or greater (n = 62) were categorized as fast progressors, and eyes with annual rates of less than −0.75% (n = 62) were categorized as slow progressors. The annual rate of visual field loss was −0.15 dB (95% CI, −0.29 to −0.01 dB) for the slow optical coherence tomography angiography progressors and −0.43 dB (95% CI, −0.58 to −0.29 dB) for the fast optical coherence tomography angiography progressors (difference, −0.28 dB; 95% CI, −0.48 to −0.08 dB; P = .006). The fast optical coherence tomography angiography progressor group was associated with the faster overall rate of visual field loss in a multivariable model after adjusting to include concurrent visual field mean deviation rate (−0.17 dB; 95% CI, −0.33 to −0.01 dB; P = .04).
Thus, the findings of this cohort study suggest that faster vessel density loss during an initial follow-up period was associated with faster concurrent and subsequent rates of visual field loss during an extended period.
Reference:
Association of Initial Optical Coherence Tomography Angiography Vessel Density Loss With Faster Visual Field Loss in Glaucoma by Takashi Nishida, et al. published in the JAMA Ophthalmology.
https://jamanetwork.com/journals/jamaophthalmology/article-abstract/2789470
Dr. Shravani Dali has completed her BDS from Pravara institute of medical sciences, loni. Following which she extensively worked in the healthcare sector for 2+ years. She has been actively involved in writing blogs in field of health and wellness. Currently she is pursuing her Masters of public health-health administration from Tata institute of social sciences. She can be contacted at editorial@medicaldialogues.in.
Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751