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  • Large Intereye Asymmetry in Vessel Density May Signal Glaucomatous Damage

    By Lynda Seminara
    Selected By: Richard K. Parrish II, MD
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    Journal Highlights

    American Journal of Ophthalmology, June 2018

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    Hou et al. measured intereye retinal vessel density of glaucomatous and healthy eyes to assess whether asym­metry may indicate early glaucomatous damage, which often is asymptomatic. They found that intereye asymmetry of vessel density is much greater in glaucoma suspects than in people with healthy eyes.

    This cross-sectional study included 55 individuals with healthy eyes, 32 glaucoma suspects, and 66 patients with mild or moderate glaucoma. Age, sex, and racial distributions were com­parable for the 3 cohorts. Retinal vessel density was measured using optical coherence tomography angiography (OCTA) of the macula and optic nerve head. Thickness of the peripapillary retinal nerve fiber layer and the macu­lar ganglion cell complex was measured with spectral-domain OCT. Intereye asymmetry was calculated as the dif­ference in vessel density and thickness between each subject’s eyes. Univariate and multivariate analyses were per­formed to compare findings.

    Results showed substantial differenc­es between the study groups. Univariate and multivariate analyses demonstrated that intereye asymmetry in both peri­papillary and macular vessel density was significantly greater for glaucoma suspects than for individuals with healthy eyes, but intereye asymmetry in thick­ness was similar for these groups. For all thickness-related parameters, there were significant differences between glaucoma suspects and glaucoma pa­tients, both with and without adjust­ment for confounders; median values for glaucoma patients were roughly double those for suspects.

    Examining intereye asymmetry of retinal vessel density may be a helpful adjunct to glaucoma screening pro­grams; a better understanding of events that precede the onset of glaucoma would facilitate early diagnosis. Lon­gitudinal studies are needed to further characterize the relationship between intereye variation in vessel density and the development and progression of glaucoma.

    The original article can be found here.