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. 2021 Dec 8:8:747720.
doi: 10.3389/fmed.2021.747720. eCollection 2021.

Associations Between the Choroidal Vascularity Index and Malignant Glaucoma After Trabeculectomy for Primary Angle Closure Glaucoma

Chengguo Zuo  1 , Dingqiao Wang  1 , Xinxing Guo  2 , Hui Xiao  1 , Shaoyang Zheng  1 , Mingkai Lin  1 , Lei Fang  1 , Xing Liu  1
Affiliations

Associations Between the Choroidal Vascularity Index and Malignant Glaucoma After Trabeculectomy for Primary Angle Closure Glaucoma

Chengguo Zuo et al. Front Med (Lausanne). .

Abstract

Purpose: To compare the choroidal vasculature characteristics by using the choroidal vascularity index (CVI) in eyes with malignant glaucoma (MG), fellow eyes with non-MG, and eyes with uncomplicated primary angle-closure glaucoma (PACG) after trabeculectomy by spectral-domain optical coherence tomography (SD-OCT). Methods: This case-control study included 53 patients diagnosed with MG after trabeculectomy. Eyes with MG (n = 53) and the fellow eyes with non-MG (n = 50) were included. Eyes with PACG without MG after trabeculectomy (n = 60) were also enrolled as controls. The choroidal parameters, including CVI and the subfoveal choroidal thickness (SFCT), were measured by using SD-OCT images. Results: Eyes with MG and the fellow eyes showed a significantly lower CVI than eyes with PACG controls (p < 0.001). After adjusting for age, sex, axial length (AL), and intraocular pressure (IOP), eyes with the greater CVI [odds ratio (OR), 0.44] were significantly related to MG. The area under the receiver operating characteristic curve of the CVI was greater than that of the SFCT in the diagnosis of MG (0.911 vs. 0.840, p = 0.034). Conclusion: Eyes with MG showed a significantly lower macular CVI than eyes with PACG controls. A higher macular CVI was an associated factor of eyes with MG. The CVI serves as a more stable and sensitive indicator for MG than the SFCT in this group of patients with PACG.

Keywords: choroid; choroidal thickness (CT); choroidal vascularity index (CVI); malignant glaucoma; optical coherence tomography (OCT).

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Original spectral-domain optical coherence tomography (SD-OCT) (A-C) and binarized SD-OCT images (D-F) of this study in eyes with malignant glaucoma (MG) group, the fellow eyes with non-MG group, and control eyes with uncomplicated primary angle-closure glaucoma (PACG) group. (A-C) Based on the prebinarized image, two horizontal red lines segment the choroid from Bruch's membrane to the choroidal–scleral interface. The vertical white line at the fovea was used for calculation of the subfoveal choroidal thickness (SFCT), which measured 485, 489, and 330 μm. (D-F) Based on the binarized image, the yellow block represents the total choroidal area (TCA), the choroidal vessel lumen area (LA) is represented by dark pixels, and the stromal area (SA) is represented by light pixels. The choroidal vascularity index (CVI) was 61.81, 60.56, and 68.09%.
Figure 2
Figure 2
Box chart representing measurements of the CVI and the SFCT across all the groups. *p < 0.05. Error bars denote 95% CIs.
Figure 3
Figure 3
The receiver operating characteristic (ROC) curves for the SFCT and the CVI to separate eyes with MG from control eyes with POCG.
See this image and copyright information in PMC

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