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

Doaa Maamoun Ashour; Nesrin Said Madkour; Weam Mohamed Ebeid; Rabab Aboelmaaty Mahmoud

doi:10.1097/IJG.0000000000002530

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

J Glaucoma. 2024 Dec 16. doi: 10.1097/IJG.0000000000002530. Online ahead of print.

Authors

Doaa Maamoun Ashour¹, Nesrin Said Madkour¹, Weam Mohamed Ebeid^{1

2}, Rabab Aboelmaaty Mahmoud¹

Affiliations

¹ Ophthalmology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
² Ophthalmology, Armed Forces College of Medicine, Cairo, Egypt.

PMID: 39670861
DOI: 10.1097/IJG.0000000000002530

Abstract

Prcis: In glaucoma, peripapillary vascular density was reduced compared to 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 three groups. Group 1 included thirty eyes with primary open angle glaucoma, group 2 included twenty-eight normal eyes with physiological cupping (vertical cup/ disc ratio 0.6 or more based on structural OCT and no evidence of glaucoma), and group 3 included forty age-matched normal eyes (vertical cup/disc ratio ≤ 0.5). Participants were subjected to ophthalmological examination, structural optical coherence tomography (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 group 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 four quadrants. No significant correlations were found between these parameters in the other groups.

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