Peripapillary Vascular Density Differentiates Glaucomatous Cupping From Physiological Cupping Using Optical Coherence Tomography Angiography.

PRÉCIS: In glaucoma, peripapillary vascular density was reduced compared with normal eyes, with or without physiological cupping.

PURPOSE: To assess the ability of radial peripapillary capillaries vessel density (RPC VD) to distinguish between physiological and glaucomatous cupping using optical coherence tomography angiography (OCTA).

PATIENTS AND

METHODS

An observational study was conducted at Ain Shams University, involving 98 eyes from 98 patients, divided into 3 groups. Group 1 included 30 eyes with primary open angle glaucoma, group 2 included 28 normal eyes with physiological cupping [vertical cup/disc ratio 0.6 or more based on structural optical coherence tomography (OCT) and no evidence of glaucoma], and group 3 included 40 age-matched normal eyes (vertical cup/disc ratio ≤0.5). Participants were subjected to ophthalmological examination, structural OCT, and OCTA of the optic disc.

RESULTS

Group 1 exhibited significantly lower RPC VD than the other groups ( P <0.001), while no significant differences were noted between groups 2 and 3 ( P =0.559). Moderate negative correlations were observed between C/D vertical ( r =-0.556, P =0.002), and horizontal ratios ( r =-0.430, P =020), and RPC VD in glaucomatous eyes across the whole image and its 4 quadrants. No significant correlations were found between these parameters in the other groups.

CONCLUSION

Using OCTA, glaucomatous eyes showed reduced RPC VD compared with normal eyes, even in the presence of physiological cupping. This finding may help to differentiate between physiological and glaucomatous cupping.