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Capillary Dropout at the Retinal Nerve Fiber Layer Defect in Glaucoma

An Optical Coherence Tomography Angiography Study

Ichiyama, Yusuke MD; Minamikawa, Takayuki MD; Niwa, Yuichi MD; Ohji, Masahito MD

doi: 10.1097/IJG.0000000000000540
Online Articles: Case Reports

Purpose: To investigate the microvasculature changes of retinal nerve fiber layer (RNFL) defects in glaucoma.

Design: The study design is a case report.

Patients and Methods: Four glaucomatous eyes were included in this observational cross-sectional study. The microvasculature changes of RNFL defects were examined using optical coherence tomography (OCT) angiography.

Results: Three eyes had apparent wedge-shaped capillary dropout on OCT angiography. In the fourth eye, detection of wedge-shaped capillary loss was difficult because of overall capillary drop out due to advanced glaucoma. Capillary dropout detection by OCT angiography was correlated with visual field loss and RNFL defect detection by regular OCT. Compared with regular OCT used to obtain retinal thickness maps, OCT angiography is often better at visualizing the borders of lesions in the RNFL.

Conclusions: OCT angiography can detect capillary dropout in RNFL defects in glaucomatous eyes, and therefore could be a useful glaucoma examination tool.

Department of Ophthalmology, Shiga University of Medical Science, Shiga, Japan

Supported in part by a grant from the Shiga University of Medical Science. The funder had no role in the design or conduction of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or decision to submit the manuscript for publication.

Disclosure: The authors declare no conflict of interest.

Reprints: Yusuke Ichiyama, MD, Department of Ophthalmology, Shiga University of Medical Science, Seta Tsukinowacho, Otsu, Shiga 520-2192, Japan (e-mail:

Received December 18, 2015

Accepted August 5, 2016

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