Regional vascular density–visual field sensitivity relationship in glaucoma according to disease severity

• Published in: British journal of ophthalmology Vol. 101; no. 12; pp. 1666 - 1672
• Main Authors: Shin, Joong Won, Lee, Jiyun, Kwon, Junki, Choi, Jaewan, Kook, Michael S
• Format: Journal Article
• Language: English
• Published: BMA House, Tavistock Square, London, WC1H 9JR BMJ Publishing Group Ltd 01.12.2017; BMJ Publishing Group LTD
• Subjects: advanced glaucoma; Algorithms; Automation; Clinical science; Cross-Sectional Studies; Defects; Female; Follow-Up Studies; Glaucoma; Glaucoma - diagnosis; Glaucoma - physiopathology; Humans; Male; Medical imaging; Middle Aged; Nerve Fibers - pathology; Optic Disk - pathology; Optic nerve; optical coherence tomography angiography; Optics; Prospective Studies; Retinal Ganglion Cells - pathology; Retinal Vessels - pathology; Severity of Illness Index; Tomography, Optical Coherence - methods; vascular density; vascular-functional relationship; Visual Field Tests; Visual Fields - physiology; vascular density; advanced glaucoma; optical coherence tomography angiography; vascular-functional relationship
• ISSN: 0007-1161; 1468-2079; 1468-2079
• DOI: 10.1136/bjophthalmol-2017-310180

AimsTo study whether there are global and regional relationships between peripapillary vascular density (pVD) assessed by optical coherence tomography angiography (OCT-A) and visual field (VF) mean sensitivity at different glaucoma stages.MethodsMicrovascular images and peripapillary retinal nerve fibre layer (pRNFL) thicknesses were obtained using a Cirrus OCT-A device in 91 glaucoma subjects. The pVD was measured at various spatial locations according to the Garway-Heath map, using a MATLAB software (The MathWorks, Natick, Massachusetts). VF mean sensitivity (VFMS) was recorded in the 1/L scale. Global and regional vasculature–function (pVD vs VFMS) relationships were assessed in separate patient groups at mild and moderate-to-advanced stages of glaucoma.ResultsThe pVDs at superotemporal and inferotemporal regions were significantly associated with corresponding VFMS in mild glaucoma (p<0.05). In moderate-to-advanced glaucoma, there were significant associations between pVD and VFMS, regardless of location. The association between global pVD and VFMS was significantly stronger than that between global pRNFL thickness and VFMS in moderate-to-advanced stage glaucoma (p <0.05).ConclusionGlobal and regional pVD measured by OCT-A was significantly associated with corresponding VFMS in moderate-to-advanced glaucoma. OCT-A may be useful in monitoring glaucoma at various stages.