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Choroidal and Retinal Features in PACD and POAG on OCT and OCTA

Status: Recruiting
Location: See location...
Study Type: Observational
SUMMARY

Glaucoma is a group of irreversible, progressive optic neuropathies that can lead to severe visual field defects and even blindness, affecting nearly 95 million people worldwide. Based on anterior chamber angle structure, glaucoma is classified into primary angle-closure glaucoma (PACG) and primary open-angle glaucoma (POAG). Although POAG is more common, PACG is more severe and more likely to cause blindness if not managed appropriately. Globally, PACG accounts for approximately 25% of all glaucoma cases but is responsible for roughly 50% of glaucoma-related blindness. Generally, the term glaucoma implies optic nerve damage; however, glaucomatous optic neuropathy may be absent in subacute and acute angle-closure glaucoma. Therefore, according to international consensus, primary angle-closure disease is categorized as PACD-encompassing primary angle-closure suspect (PACS), primary angle closure (PAC), and PACG-based on the extent of angle closure, intraocular pressure elevation, and optic nerve damage. With advances in ophthalmic imaging, an increasing array of diagnostic modalities has been applied to glaucoma diagnosis. Optical coherence tomography (OCT), which utilizes low-coherence light to display cross-sectional images of the retina in vivo, represents a rapid, non-invasive, and continuously evolving imaging method. Building upon OCT, OCTA has emerged as a novel imaging technique that allows non-invasive visualization and assessment of blood flow in individual retinal layers \[5\]. Existing OCT and OCTA research on glaucoma primarily focuses on the optic disc and macula of glaucoma patients, providing evidence of changes in the retinal nerve fiber layer, macular ganglion cell thickness, optic nerve head structure, and peripapillary and macular vasculature. Other studies have examined choroidal vascular architecture and thickness in glaucoma; previous findings from our research group also indicate that choroidal vascular density is significantly lower in eyes with POAG and PACG compared to normal eyes, while choroidal stromal area is significantly greater in PACG than in POAG eyes and normal controls. Further investigation into choroidal and retinal alterations in glaucoma is warranted. Consequently, the OCT and OCTA fundus characteristics of patients with PACD and POAG remain an area with unexplored unknowns. This study utilizes OCT and OCTA to observe the choroidal and retinal tissue structure and vascular hemodynamics in patients with PACD and POAG, aiming to comprehensively investigate structural changes in the glaucomatous fundus, broaden new research directions, and explore and supplement the understanding of glaucoma pathogenesis.

Eligibility
Participation Requirements
Sex: All
Minimum Age: 18
Maximum Age: 90
Healthy Volunteers: t
View:

• Control group: Healthy individuals with no history of ocular surgery, IOP \< 21 mmHg, and CDR \< 0.5 bilaterally without asymmetry

• Observation group: Glaucoma specialist-confirmed diagnosis of POAG or PACD (per ISGEO staging: PACS/PAC/PACG)

Locations
Other Locations
China
Zhongshan Ophthalmic Center, Sun Yat-sen University
RECRUITING
Guangzhou
Contact Information
Primary
Yuheng Tan
tanyuhesper@163.com
+02066615461
Time Frame
Start Date: 2024-07-16
Estimated Completion Date: 2027-04-20
Participants
Target number of participants: 132
Treatments
Control Group
Inclusion Criteria:~1. Individuals undergoing routine physical examination, generally in good health, with no history of prior surgery.~2. No use of glaucoma medications, no evidence of elevated intraocular pressure (IOP \< 21 mmHg), no significant optic nerve head (ONH) asymmetry (cup-to-disc ratio difference \< 0.2), and cup-to-disc ratio (CDR) \< 0.5 in both eyes.~3. Age between 18 and 90 years, inclusive; any gender.~Exclusion Criteria:~1. Known history of retinal disease, including any condition involving macular degeneration (e.g., age-related macular degeneration, diabetic retinopathy, retinal vein occlusion, viral retinitis, or epiretinal membrane).~2. Optic nerve abnormalities other than glaucoma, such as those associated with neurological complications (e.g., Multiple Sclerosis, Neuromyelitis Optica).~3. Poor quality of OCT or OCTA images obtained post-examination.~4. Refusal to sign the informed consent form.
Observation Group
Inclusion Criteria:~1. Confirmed diagnosis of Primary Open-Angle Glaucoma (POAG) or Primary Angle-Closure Disease (PACD) by a glaucoma specialist. The diagnosis of POAG is based on standard clinical criteria, specifically: presence of an open angle, glaucomatous optic neuropathy, current or past elevation of intraocular pressure, and visual field defects \[10\]. PACD cases are diagnosed and enrolled according to the clinical staging system of PACS, PAC, and PACG as established by the International Society of Geographical and Epidemiological Ophthalmology (ISGEO) .~2. Age between 18 and 90 years, inclusive; any gender.~Exclusion Criteria:~1. Known history of retinal disease, including any condition involving macular degeneration (e.g., age-related macular degeneration, diabetic retinopathy, retinal vein occlusion, viral retinitis, or epiretinal membrane).~2. Optic nerve abnormalities other than glaucoma, such as those observed in patients with neurological com
Sponsors
Leads: Zhongshan Ophthalmic Center, Sun Yat-sen University

This content was sourced from clinicaltrials.gov