{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T07:34:06Z","timestamp":1769758446183,"version":"3.49.0"},"reference-count":35,"publisher":"BMJ","issue":"3","funder":[{"name":"A grant of Patient-Centered Clinical Research Coordinating Center funded by the Ministry of Health & Welfare, Republic of Korea","award":["HI19C0481, HC19C0276"],"award-info":[{"award-number":["HI19C0481, HC19C0276"]}]},{"name":"Seoul National University Bundang Hospital Research Fund","award":["14-2022-0024"],"award-info":[{"award-number":["14-2022-0024"]}]},{"name":"National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science, and Technology","award":["2016R1D1A1B02011696"],"award-info":[{"award-number":["2016R1D1A1B02011696"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Br J Ophthalmol"],"accepted":{"date-parts":[[2023,1,11]]},"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:sec><jats:title>Background\/aims<\/jats:title><jats:p>To compare the influence of choroidal microvasculature dropout (cMvD) on progressive retinal nerve fibre layer (RNFL) thinning in glaucomatous eyes with parapapillary \u03b2-zones and \u03b3-zones.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>294 eyes with primary open-angle glaucoma (POAG) and parapapillary atrophy (PPA) underwent optical coherence tomography (OCT) to determine the type of PPA and OCT angiography scanning of the optic nerve head to determine the presence of cMvD. Eyes were classified based on the type of PPA (\u03b2-zones and \u03b3-zones), and their clinical characteristics were compared. Factors associated with the rate of rapid progressive RNFL thinning were determined in each group, including the presence of cMvD as an independent variable.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 294 eyes, 186 and 108 were classified as having \u03b2-zones and \u03b3-zones, respectively. The rate of RNFL thinning was slower (p&lt;0.001), axial length was longer (p&lt;0.001) and presence of cMvD was less frequent (57.4% vs 73.1%, p=0.006) in eyes with \u03b3-zone than those with \u03b2-zone. Multivariate analyses showed that greater lamina cribrosa curvature (p=0.047) and the presence of cMvD (p=0.010) were associated with a faster rate of RNFL thinning in eyes with \u03b2-zone, whereas larger intraocular pressure fluctuation (p&lt;0.001), shorter axial length (p=0.042) and greater baseline RNFL thickness (p&lt;0.001) were associated with a faster rate of RNFL thinning in eyes with \u03b3-zone.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The presence of cMvD was significantly associated with a faster rate of RNFL thinning in POAG eyes with \u03b2-zone, but not \u03b3-zone. The pathogenic consequences of cMvD in POAG eyes may depend on accompanying peripapillary structures.<\/jats:p><\/jats:sec>","DOI":"10.1136\/bjo-2022-322505","type":"journal-article","created":{"date-parts":[[2023,1,23]],"date-time":"2023-01-23T18:20:32Z","timestamp":1674498032000},"page":"357-365","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Influence of choroidal microvasculature dropout on progressive retinal nerve fibre layer thinning in primary open-angle glaucoma: comparison of parapapillary \u03b2-zones and \u03b3-zones"],"prefix":"10.1136","volume":"108","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4648-7083","authenticated-orcid":false,"given":"Hye Seong","family":"Hwang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9393-9452","authenticated-orcid":false,"given":"Eun Ji","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeong-Ah","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2189-2821","authenticated-orcid":false,"given":"Seung Hyen","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5180-0978","authenticated-orcid":false,"given":"Tae-Woo","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2023,1,23]]},"reference":[{"key":"2024022109050588000_108.3.357.1","doi-asserted-by":"publisher","DOI":"10.1016\/S1350-9462(01)00004-0"},{"key":"2024022109050588000_108.3.357.2","doi-asserted-by":"publisher","DOI":"10.3129\/i08-042"},{"key":"2024022109050588000_108.3.357.3","doi-asserted-by":"publisher","DOI":"10.1136\/bjo.80.9.812"},{"key":"2024022109050588000_108.3.357.4","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1016\/j.ajo.2015.06.024","article-title":"Relationship between juxtapapillary choroidal volume and beta-zone parapapillary atrophy in eyes with and without primary open-angle glaucoma","volume":"160","author":"Sullivan-Mee","year":"2015","journal-title":"Am J Ophthalmol"},{"key":"2024022109050588000_108.3.357.5","doi-asserted-by":"crossref","first-page":"1209","DOI":"10.1016\/j.ophtha.2017.03.039","article-title":"Parapapillary choroidal microvasculature dropout in glaucoma: a comparison between optical coherence tomography angiography and indocyanine green angiography","volume":"124","author":"Lee","year":"2017","journal-title":"Ophthalmology"},{"key":"2024022109050588000_108.3.357.6","doi-asserted-by":"publisher","DOI":"10.1136\/bjophthalmol-2017-311136"},{"key":"2024022109050588000_108.3.357.7","doi-asserted-by":"crossref","first-page":"2509","DOI":"10.1016\/j.ophtha.2016.09.002","article-title":"Deep retinal layer microvasculature dropout detected by the optical coherence tomography angiography in glaucoma","volume":"123","author":"Suh","year":"2016","journal-title":"Ophthalmology"},{"key":"2024022109050588000_108.3.357.8","doi-asserted-by":"crossref","first-page":"1621","DOI":"10.1167\/iovs.17-21440","article-title":"Underlying microstructure of parapapillary deep-layer capillary dropout identified by optical coherence tomography angiography","volume":"58","author":"Lee","year":"2017","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"2024022109050588000_108.3.357.9","doi-asserted-by":"crossref","first-page":"3004","DOI":"10.1167\/iovs.17-21918","article-title":"Parapapillary deep-layer microvasculature dropout in glaucoma: topographic association with glaucomatous damage","volume":"58","author":"Lee","year":"2017","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"2024022109050588000_108.3.357.10","doi-asserted-by":"crossref","first-page":"1003","DOI":"10.1016\/j.ophtha.2018.01.016","article-title":"Choroidal microvasculature dropout is associated with progressive retinal nerve fiber layer thinning in glaucoma with disc hemorrhage","volume":"125","author":"Park","year":"2018","journal-title":"Ophthalmology"},{"key":"2024022109050588000_108.3.357.11","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/j.ajo.2018.12.007","article-title":"Parapapillary deep-layer microvasculature dropout and visual field progression in glaucoma","volume":"200","author":"Kwon","year":"2019","journal-title":"Am J Ophthalmol"},{"key":"2024022109050588000_108.3.357.12","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/j.ogla.2019.10.001","article-title":"Influence of choroidal microvasculature dropout on the rate of glaucomatous progression: a prospective study","volume":"3","author":"Lee","year":"2020","journal-title":"Ophthalmol Glaucoma"},{"key":"2024022109050588000_108.3.357.13","doi-asserted-by":"crossref","first-page":"3343","DOI":"10.1167\/iovs.18-26519","article-title":"Elucidation of the strongest factors influencing rapid retinal nerve fiber layer thinning in glaucoma","volume":"60","author":"Lee","year":"2019","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"2024022109050588000_108.3.357.14","first-page":"908","article-title":"Parapapillary chorioretinal atrophy in normal and glaucoma eyes. I. morphometric data","volume":"30","author":"Jonas","year":"1989","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"2024022109050588000_108.3.357.15","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0047237","article-title":"Parapapillary atrophy: histological gamma zone and delta zone","volume":"7","author":"Jonas","year":"2012","journal-title":"PLoS One"},{"key":"2024022109050588000_108.3.357.16","doi-asserted-by":"crossref","first-page":"1341","DOI":"10.1016\/j.ophtha.2014.01.008","article-title":"Microstructure of \u03b2-zone parapapillary atrophy and rate of retinal nerve fiber layer thinning in primary open-angle glaucoma","volume":"121","author":"Kim","year":"2014","journal-title":"Ophthalmology"},{"key":"2024022109050588000_108.3.357.17","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2013.02.011"},{"key":"2024022109050588000_108.3.357.18","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2008.05.032"},{"key":"2024022109050588000_108.3.357.19","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-018-32499-8","article-title":"Steeper structure-function relationship in eyes with than without a parapapillary deep-layer microvasculature dropout","volume":"8","author":"Kim","year":"2018","journal-title":"Sci Rep"},{"key":"2024022109050588000_108.3.357.20","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.16-20802"},{"key":"2024022109050588000_108.3.357.21","doi-asserted-by":"crossref","first-page":"5006","DOI":"10.1167\/iovs.15-18982","article-title":"Reduction of the lamina cribrosa curvature after trabeculectomy in glaucoma","volume":"57","author":"Lee","year":"2016","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"2024022109050588000_108.3.357.22","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-018-19321-1","article-title":"Ocular and clinical characteristics associated with the extent of posterior lamina cribrosa curve in normal tension glaucoma","volume":"8","author":"Lee","year":"2018","journal-title":"Sci Rep"},{"key":"2024022109050588000_108.3.357.23","doi-asserted-by":"crossref","unstructured":"Zuur AF , Ieno EN , Walker N , et al . Mixed effects models and extensions in ecology with R. In: Mixed Effects Models and Extensions in Ecology with R. 1st 2009. New York, NY: Springer, 2009. doi:10.1007\/978-0-387-87458-6","DOI":"10.1007\/978-0-387-87458-6_1"},{"key":"2024022109050588000_108.3.357.24","doi-asserted-by":"crossref","first-page":"S5","DOI":"10.1016\/S0039-6257(99)00046-6","article-title":"Introductory comments on blood flow autoregulation in the optic nerve head and vascular risk factors in glaucoma","volume":"43 Suppl 1","author":"Anderson","year":"1999","journal-title":"Surv Ophthalmol"},{"key":"2024022109050588000_108.3.357.25","doi-asserted-by":"publisher","DOI":"10.1016\/S0161-6420(99)00037-8"},{"key":"2024022109050588000_108.3.357.26","doi-asserted-by":"crossref","DOI":"10.1155\/2020\/6279689","article-title":"Topographic relationship with a retinal nerve fiber layer defect differs between beta-zone and gamma-zone parapapillary atrophy","volume":"2020","author":"Jung","year":"2020","journal-title":"J Ophthalmol"},{"key":"2024022109050588000_108.3.357.27","doi-asserted-by":"crossref","DOI":"10.1167\/iovs.63.6.20","article-title":"Characteristics of the optic nerve head in myopic eyes using swept-source optical coherence tomography","volume":"63","author":"Cheng","year":"2022","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"2024022109050588000_108.3.357.28","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.10-6600"},{"key":"2024022109050588000_108.3.357.29","doi-asserted-by":"publisher","DOI":"10.1111\/j.1442-9071.2012.02762.x"},{"key":"2024022109050588000_108.3.357.30","doi-asserted-by":"crossref","first-page":"2423","DOI":"10.1167\/iovs.19-26828","article-title":"Intereye comparison of lamina cribrosa curvature in normal tension glaucoma patients with unilateral damage","volume":"60","author":"Kim","year":"2019","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"2024022109050588000_108.3.357.31","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1097\/ICU.0000000000000548","article-title":"Myopic optic disc changes and its role in glaucoma","volume":"30","author":"Tan","year":"2019","journal-title":"Curr Opin Ophthalmol"},{"key":"2024022109050588000_108.3.357.32","doi-asserted-by":"publisher","DOI":"10.1136\/bjophthalmol-2019-315441"},{"key":"2024022109050588000_108.3.357.33","doi-asserted-by":"publisher","DOI":"10.1097\/OPX.0b013e3181940669"},{"key":"2024022109050588000_108.3.357.34","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.03-1363"},{"key":"2024022109050588000_108.3.357.35","doi-asserted-by":"crossref","first-page":"1331","DOI":"10.1007\/s00417-016-3332-z","article-title":"Progression of primary open angle glaucoma in asymmetrically myopic eyes","volume":"254","author":"Song","year":"2016","journal-title":"Graefes Arch Clin Exp Ophthalmol"}],"container-title":["British Journal of Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bjo-2022-322505","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,2,21]],"date-time":"2024-02-21T17:08:33Z","timestamp":1708535313000},"score":1,"resource":{"primary":{"URL":"https:\/\/bjo.bmj.com\/lookup\/doi\/10.1136\/bjo-2022-322505"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,23]]},"references-count":35,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2024,2,21]]},"published-print":{"date-parts":[[2024,3]]}},"alternative-id":["10.1136\/bjo-2022-322505"],"URL":"https:\/\/doi.org\/10.1136\/bjo-2022-322505","relation":{},"ISSN":["0007-1161","1468-2079"],"issn-type":[{"value":"0007-1161","type":"print"},{"value":"1468-2079","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,23]]}}}