Evaluation of Radial Peripapillary Capillary Density in G6PD Deficiency: An OCT Angiography Pilot Study

Glucose-6-phosphate-dehydrogenase (G6PD) deficiency is an inherited enzymatic disorder causing hemolytic anemia. The purpose of this pilot study was to compare vascular density (VD) values of the radial peripapillary capillary (RPC) plexus in G6PD-deficient and G6PD-normal men, using optical coherence tomography angiography (OCTA). Methods: 46 G6PD-deficient men and 23 age-matched male controls were included. A complete ophthalmological evaluation, consisting of slit-lamp biomicroscopy, best-corrected visual acuity, intra-ocular pressure measurement, structural optical coherence tomography, and OCTA scanning of the optic nerve head, was performed. The en-face angioflow images were carefully analyzed and the VD values of the RPC plexus were measured using the AngioAnalytics™ software embedded in the OCTA device. Medical conditions, including systemic hypertension, hypercholesterolemia, and diabetes mellitus, were also investigated. Results: G6PD-deficient eyes showed higher values of VD in all peripapillary sectors, but a statistical significance (p = 0.03) was reached only in the infero-temporal sector. There were no significant differences in terms of hypercholesterolemia, systemic arterial hypertension, and diabetes mellitus between the two study groups. Conclusion: Results show that VD values of the RPC plexus are higher in G6PD-deficient men than in G6PD-normal subjects, but a statistically significant difference was found only in the inferior temporal sector. Overall, our preliminary findings support the hypothesis that the RPC layer of G6PD-deficient men consists of a denser vascular network, which may contribute to offering protection against ocular atherosclerotic vasculopathies.