Choriocapillary Vessel Density May Help Detect Glaucomatous Microvascular Changes

Patients with preperimetric glaucoma (PPG) and advanced glaucoma (AG) may have a significantly lower choriocapillary vessel density (CCVD) compared with healthy individuals, according to research published in Photodiagnosis and Photodynamic Therapy. These findings indicate that CCVD may be a useful biomarker for identifying microvascular changes in patients with PPG. 

Researchers conducted a prospective, observational analysis consisting of patients with PPG (n=19; mean age, 55 years; 10 men), individuals with AGG (n=18; mean age, 52 years; 11 men) and control group participants (n=20; mean age, 56 years; 11 men). All participants underwent enhanced depth imaging optical coherence tomography (EDI-OCT) to determine subfoveal choroidal thickness (SFCT) and optical coherence tomography angiography (OCT-A) to assess CCVD.

Patients in the PPG and AG groups exhibited a statistically significant decrease in CCVD compared with control individuals (P <.001 for both). The EDI-OCT analysis revealed that patients with AG had a statistically significant increase in SFCT compared with control group participants (P <.001), while no statistically significant difference was observed between individuals in the PPG and control groups (P =.851). 

“Here, we reported that CCVD was significantly lower in PPG and in advanced glaucoma patients compared to the control group and choroidal thickness was greater in advanced glaucoma patients than PPG and controls groups. Therefore the CCVD significantly discriminates glaucoma patients from controls,” according to the researchers. “[T]he CCVD and the [choroidal thickness] values could be an early biomarker useful to discriminate pre perimetric glaucomatous eyes from healthy eyes and to improve our knowledge of pathogenesis of glaucoma disease.”

Study limitations include the limited sample size of patients and potential confounding due to the use of beta blockers in patients with glaucoma.