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. 2025 Jul 3;15(13):1700.
doi: 10.3390/diagnostics15131700.

Retinal Vessel Diameter Reductions Are Associated with Retinal Ganglion Cell Dysfunction, Thinning of the Ganglion Cell and Inner Plexiform Layers, and Decreased Visual Field Global Indices in Glaucoma Suspects

Andrew Tirsi  1   2 , Nicholas Leung  2 , Rohun Gupta  2 , Sungmin Hong  2 , Derek Orshan  3 , Joby Tsai  4 , Corey Ross Lacher  5 , Isabella Tello  1 , Samuel Potash  6 , Timothy Foster  2 , Rushil Kumbhani  2 , Celso Tello  1   2
Affiliations

Retinal Vessel Diameter Reductions Are Associated with Retinal Ganglion Cell Dysfunction, Thinning of the Ganglion Cell and Inner Plexiform Layers, and Decreased Visual Field Global Indices in Glaucoma Suspects

Andrew Tirsi et al. Diagnostics (Basel). .

Abstract

Background/Objectives: The aim of this study was to evaluate the associations between optical coherence tomography angiography (OCTA)-based retinal vessel diameter (RVD) measurements, with retinal ganglion cell (RGC) function assessed by means of steady-state pattern electroretinography (ssPERG) using ganglion cell layer-inner plexiform layer thickness (GCL-IPLT) measurements and with Humphrey field analyzer (HFA) global indices in glaucoma suspects (GSs). Methods: Thirty-one eyes (20 participants) underwent a comprehensive ophthalmologic examination, ssPERG measurements utilizing the PERGLA paradigm, HFA, optical coherence tomography (OCT), and OCTA. The OCTA scans were processed using ImageJ software, Version 1.53, allowing for measurement of the RVD. Multiple linear regression models were used. Results: After controlling for age, race, central corneal thickness (CCT), and spherical equivalent (SE), a linear regression analysis found that the RVD explained the 4.7% variance in magnitude (Mag) (p = 0.169), 9.2% variance in magnitudeD (MagD) (p = 0.021), and 16.9% variance in magnitudeD/magnitude (p = 0.009). After controlling for age, CCT, and signal strength (SS), a linear regression analysis found that the RVD was significantly associated with the GCL-IPLT measurements (average GCL-IPL, minimum GCL-IPL, superior, superonasal, inferior, and inferonasal sectors) (p ≤ 0.023). An identical regression analysis where the RVD was replaced with the PERG parameters showed a significant association between the MagD and almost all GCI-IPLT measurements. RVD measurements were significantly associated with HFA VFI 24-2 (p = 0.004), MD 24-2 (p < 0.001), and PSD 24-2 (p = 0.009). Conclusions: Decreased RVD measurements were significantly associated with RGC dysfunction, decreased GCL-IPLT, and all HFA global indices in the GSs.

Keywords: Humphrey field analyzer global indices; OCTA; PERG; glaucoma; retinal ganglion cell; retinal vessel diameter.

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Conflict of interest statement

Authors Celso Tello and Andrew Tirsi are consultants for Diopsys Inc. All other authors certify that they have no affiliations or involvement with any organizations with a financial interest or non-financial interest in the subject matter discussed in this manuscript. Andrew Tirsi, Diopsys Inc., C; Nicholas Leung, none; Rohun Gupta, none; Sungmin Hong, none; Derek Orshan, none; Joby Tsai, none; Corey Lacher, none; Cindy Takigawa, none; Isabella Tello, none; Timothy Foster, none; Rushil Kumbhani, none; Stephen A Obstbaum, none; Celso Tello, Diopsys Inc., C.

Figures

Figure 1
Figure 1
The methodology of how the Vessel Analysis software on ImageJ calculates retinal vessel diameter. Top left (A) is the unfiltered image of the superficial plexus of the retinal vasculature. The image is binarized (B) and subsequently skeletonized (C) The Image Analysis software converts the black and white skeletonized image into a colorized skeletonized image (D). The color scale represents different degrees of vessel thickness.
Figure 2
Figure 2
The left image is the unfiltered OCTA image of the superficial plexus. The right image is the same image processed by the Vessel Analysis software for ImageJ. This subject had lower retinal vessel diameter relative to the other glaucoma suspects.
Figure 3
Figure 3
The left image is the unfiltered OCTA image of the superficial plexus. The right image is the same image processed by the Vessel Analysis software for ImageJ. This subject had higher retinal vessel diameter relative to the other glaucoma suspects.
Figure 4
Figure 4
Scatter plot of the relationship between magnitude and retinal vessel diameter after adjusting for age, SE, race, and CCT (r2 = 0.102, p = 0.169).
Figure 5
Figure 5
Scatter plot of the relationship between magnitudeD and retinal vessel diameter after adjusting for age, SE, race, and CCT (r2 = 0.262, p = 0.021).
Figure 6
Figure 6
Scatter plot fo the relationship between magnitudeD/magnitude ratio and retinal vessel diameter after adjusting for age, SE, race, and CCT (r2 = 0.322, p = 0.009).
See this image and copyright information in PMC

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