2025 - 4 Issue

Original article

Vessel Density and Retinal Nerve Fiber Layer in Pathological Intraocular Pressure

Jakub Král ORCID
Ján Lešták ORCID – Martin Fůs ORCID

Full Text links

DOI: 10.31348/2025/16

Published in Czech and Slovak Ophtalmology: 2025 - 4

Published on website: 13.02.2025

Keywords: vessel density, retinal nerve fiber layer, intraocular pressure

Summary

Aim: The aim of the study was to determine the correlation between intraocular pressure (IOP) and thickness of the retinal nerve fiber layer (RNFL), and vascular density (VD) in the optic nerve.

Material and methodology: IOP was greater than 21 mmHg (21–36 mmHg) in all eyes and was measured as the result of an average of three measurements with the instrument Ocular Response Analyzer (ORA, Reichert). RNFL and VD thickness (in the papillary region of 4.5 x 4.5 mm) was measured with the instrument Avanti RTVue XR (Optovue). In the case of the VD, the scan area was further separated into individual anatomical segments. In the case of corrected RNFL (RNFLc), the VD value was subtracted from the total RNFL value. The relationship of IOP to VD, RNFL and RNFLc in each peripapillary segment was determined using a Pearson’s correlation coefficient.

Results: The most significant correlation with IOP was observed for small vessel VD in a full scan (r = -0.48) and VD in the IT segment (r = -0.48). A similar correlation was observed for IOP and RNFL (r = -0.42). No statistically significant correlation was observed for RNFLc.

Conclusion: We demonstrated that VD values, specifically WI-VDs and peripapillary VDs in the IT segment, are significant markers for the early diagnosis of glaucoma.

References

  1. Burgoyne CF, Downs JC, Bellezza AJ, Suh JK, Hart RT. The optic nerve head as a biomechanical structure: a new paradigm for understanding the role of IOP-related stress and strain in the pathophysiology of glaucomatous optic nerve head damage. Prog Retin Eye Res. 2005;24:39-73.
  2. Weinreb RN, Aung T, Medeiros FA. The pathophysiology and treatment of glaucoma: a review. Jama. 2014;311:1901-1911.
  3. Gedde SJ, Vinod K, Wright MM, et al. Primary Open-Angle Glaucoma Preferred Practice Pattern®. Ophthalmology. 2021;128:71-150.
  4. Soto I, Oglesby E, Buckingham BP. et al. Retinal Ganglion Cells Downregulate Gene Expression and Lose Their Axons within the Optic Nerve Head in a Mouse Glaucoma Model. J Neurosci. 2008;28:548-561.
  5. Tao X, Sigireddi RR, Westenskow PD, Channa R, Frankfort BJ. Single transient intraocular pressure elevations cause prolonged retinal ganglion cell dysfunction and retinal capillary abnormalities in mice. Exp Eye Res. 2020;201:108296. doi: 10.1016/j. exer.2020.108296
  6. Pitale PM, Shen G, Sigireddi RR, et al. Selective vulnerability of the intermediate retinal capillary plexus precedes retinal ganglion cell loss in ocular hypertension. Front Cell Neurosci. 2022;16:1073786. doi: 10.3389/fncel.2022.1073786
  7. Kral J, Lestak J, Nutterova E. OCT angiography, RNFL and visual field at different values of intraocular pressure. Biomed Rep, 2022 May;16(5):36. doi: 10.3892/br.2022.1519
  8. Lešták J, Fůs M, Král J. The Relationship Between the Thickness of cpRNFL in Segments and Intraocular Pressure. Clin Ophthalmol. 2022;16:1-7.
  9. Lešták J, Fůs M, Král J. Axons of retinal ganglion cells on the optic nerve disc following vessel density correction at diferent IOP values. Exp Ther Med. 25; 261, 2023. doi: 10.3892/etm.2023.11960
  10. Lestak J, Fůs M, Pitrova S. Peripapillary retinal nerve fiber layer following vessel density correction at different IOP values. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2024;17. doi: 10.5507/bp.2024.001
  11. Usui Y, Westenskow PD, Kurihara T, et al. Neurovascular crosstalk between interneurons and capillaries is required for vision. J Clin Invest. 2015;125:2335-2346. doi: 10.1172/JCI80297
  12. Nian, S., Lo ACY, Mi Y, Ren K. Neurovascular unit in diabetic retinopathy: pathophysiological roles and potential therapeutical targets. Eye Vis (Lond). 2021;8:15. doi: 10.1186/s40662-021-00239-1
  13. Della Santina L, Inman DM, Lupien CB, Horner PJ, Wong ROL. Differential progression of structural and functional alterations in distinct retinal ganglion cell types in a mouse model of glaucoma. J Neurosci. 2013;33:17444-17457. doi: 10.1523/JNEUROS- CI.5461-12.2013
  14. El-Danaf RN, Huberman AD. Characteristic patterns of dendritic remodeling in early-stage glaucoma: evidence from genetically identified retinal ganglion cell types. J Neurosci. 2015;35:2329- 2343. doi: 10.1523/JNEUROSCI.1419-14.2015
  15. Ou Y, Jo RE, Ullian EM, Wong ROL, Della Santina L. Selective vulnerability of specific retinal ganglion cell types and synapses after transient ocular hypertension. J Neurosci. 2016;36:9240–9252. doi: 10.1523/JNEUROSCI.0940-16.2016
  16. Sabharwal J, Seilheimer RL, Tao X, Cowan CS, Frankfort BJ, Wu SM. Elevated IOP alters the space-time profiles in the center and surround of both ON and OFF RGCs in mouse. Proc Natl Acad Sci USA. 2017;114:8859-8864. doi: 10.1073/pnas.1706994114
  17. Campbell JP, Zhang M, Hwang TS, et al. Detailed Vascular Anatomy of the Human Retina by Projection-Resolved Optical Coherence Tomography Angiography. Sci Rep. 2017;10:7:42201. doi: 10.1038/ srep42201
  18. Chen HS, Liu CH, Wu WC, Tseng HJ, Lee YS. Optical Coherence Tomography Angiography of the Superficial Microvasculature in the Macular and Peripapillary Areas in Glaucomatous and Healthy Eyes. Invest Ophthalmol Vis Sci. 2017;58:3637-3645.
  19. Yarmohammadi A, Zangwill LM, Diniz-Filho A, et al. Optical coherence tomography angiography vessel density in healthy, glaucoma suspect and glaucoma eyes. Invest Ophthalmol Vis Sci. 2016;57:451-459. doi: 10.1167/iovs.15-18944
  20. Jia Y, Simonett JM, Wang J, et al. Wide-field OCT angiography investigation of the relationship between radial peripapillary capillary plexus density and nerve fiber layer thickness. Invest Ophthalmol Vis Sci. 2017;58:5188-5194. doi: 10.1167/iovs.17-22593
  21. Liu L, Edmunds B, Takusagawa H L, et al. Projection-resolved optical coherence tomography angiography of the peripapillary retina in glaucoma. Am J Ophthalmol. 2019;207: 99-109. doi: 10.1016/j. ajo.2019.05.024
  22. Akil H, Huang AS, Francis BA, Sadda SR, Chopra V. Retinal vessel density from optical coherence tomography angiography to differentiate early glaucoma, pre-perimetric glaucoma and normal eyes. PLoS ONE. 2017;12:1-12.
  23. Yu PK, Cringle SJ, Yu DY. Correlation between the radial peripapillary capillaries and the retinal nerve fibre layer in the normal human retina. Exp Eye Res. 2014;129:83-92. doi: 10.1016/j.exer.2014.10.020
  24. Lee EJ, Lee KM, Lee SH, Kim TW. OCT Angiography of the peripapillary retina in primary open-angle glaucoma. Invest Ophthalmol Vis Sci. 2016;57:6265-6270. doi: 10.1167/iovs.16-20287
  25. Triolo G, Rabiolo A, Shemonski ND, et al. Optical Coherence tomography angiography macular and peripapillary vessel perfusion density in healthy subjects, glaucoma suspects, and glaucoma patients. Invest Ophthalmol Vis Sci. 2017;58:5713-5722. doi: 10.1167/ iovs.17-22865
  26. Feher J, Pescosolido N, Tranquilli Leali FM, Cavalloti C. Microvessels of the human optic nerve head: Ultrastructural and radioreceptorial changes in eyes with increased IOP. Can J Ophthalmol. 2005;40:492-498.
  27. Chen HS, Liu CH, Wu WC, Tseng HJ, Lee YS. Optical Coherence Tomography Angiography of the Superficial Microvasculature in the Macular and Peripapillary Areas in Glaucomatous and Healthy Eyes. Invest Ophthalmol Vis Sci. 2017;58:3637-3645. doi: 10.1167/ iovs.17-21846
  28. Öztürk C, Güngör SG, Ekşioğlu Ü, Sezenöz AS, Çolak M. Peripapillary and macular vascular densities in healthy, ocular hypertensive, and different stages of glaucomatous eyes. Int J Ophthalmol. 2023;18:16(12):2018-2026.
  29. Mansoori T, Sivaswamy J, Gamalapati JS, Balakrishna N. Radial Peripapillary Capillary Density Measurement Using Optical Coherence Tomography Angiography in Early Glaucoma. J Glaucoma. 2017;26:438-443.