Choriocapillaris and progressive ganglion cell-inner plexiform layer loss in non-glaucomatous eyes

Aims To explore the relationship between choriocapillaris (CC) flow deficit percentage (FD%) and ganglion cell-inner plexiform layer (GCIPL) thickness in a population-based sample of non-glaucomatous eyes. Methods This is a longitudinal cohort study and prospective cross-sectional study. Non-glaucoma Chinese subjects aged 18 years or older were enrolled. All participants underwent a detailed ophthalmic examination, including swept-source optical coherence tomography (SS-OCT) and SS-OCT angiography. Average, inner average, outer average and nine Early Treatment Diabetic Retinopathy Study sub-regions of GCIPL thickness and CC FD% were measured. The correlation between CC FD% and GCIPL was assessed using a linear regression model, and the relationship between the rate of change of GCIPL thickness and CC FD% was further validated in a 2year longitudinal study. Results In the cross-sectional study including 3514 participants (3514 non-glaucoma eyes), a higher CC FD% was significantly associated with a thinner GCIPL (beta=-0.32; 95% CI -0.43 to -0.21; p<0.001). Further, in a longitudinal study (453 eyes of 453 participants), a faster increase in CC FD% was found to be significantly associated with a faster decrease in GCIPL thickness (beta=-0.10; 95% CI -0.17 to -0.03; p=0.004) after adjusting for age, sex, axial length and image quality score. Conclusions This is the first time to show that CC FD% and GCIPL thickness were correlated in both cross-sectional and longitudinal studies of non-glaucomatous individuals, which may potentially provide further insights on the role of CC perfusion in glaucoma development and progression.

Automated summary

This study explores the relationship between choriocapillaris flow deficit percentage (FD%) and ganglion cell-inner plexiform layer (GCIPL) thickness in a non-glaucomatous population. The results show a significant correlation between CC FD% and GCIPL thickness, which could provide insights on the development and progression of glaucoma.