Quantifying positional variation of retinal blood vessels in glaucoma

Abstract

We studied the relationship between major retinal blood vessel (BV) positions and glaucoma parameters based on pairs of Cirrus optical coherence tomography scans and Humphrey visual fields of 445 eyes from 445 glaucoma patients in our cross-sectional study. A trained observer marked the major superior and inferior temporal BV (artery and vein) positions on four concentric circles around the optic disc. Analysis of variance was performed to analyze the group differences of BV positions related to the factors of radius, BV type, myopia status and glaucoma stage. Subsequent t-tests were implemented to further study the effect of glaucoma stage on BV positions. The radial variations of BV positions were correlated to mean deviation and circumpapillary retinal nerve fiber layer thickness (cpRNFLT). We found significant main effects of BV type, radius and myopia status for superior and inferior BV positions and of glaucoma stage for superior BV positions (all p≤0.006) with significant superior artery nasalization in advanced compared to mild glaucoma on the two smallest circles (subsequent t-tests, p<0.05). In addition, MD (r = -0.10, p = 0.04) and cpRNFLT (r = -0.12, p = 0.02) were significantly correlated to the angle difference of superior arteries between the innermost and outermost circles. In conclusion, we demonstrated that peripapillary superior artery positions are significantly nasalized for advanced glaucoma.