Progressive peripapillary capillary vessel density loss and long‐term visual field progression in Normal tension glaucoma

• Published in: Acta ophthalmologica (Oxford, England) Vol. 102; no. 5; pp. e746 - e753
• Main Authors: Chen, De‐Fu, Wang, Chenmin, Zhou, Weihe, Si, Yuqing, Chu, Xizhong, Hu, Chengju, Shang, Xiao, Wang, Xiaoyan, Zuo, Jingjing, Huang, Qiangjie, Lu, Xiaonan, Cheng, Gangwei, Leung, Dexter Y. L., Liang, Yuanbo
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.08.2024
• Subjects: Aged; Angiography; Capillaries - pathology; Capillaries - physiopathology; Disease Progression; Female; Fluorescein Angiography - methods; Follow-Up Studies; Fundus Oculi; Glaucoma; glaucoma progression; Humans; Intraocular Pressure - physiology; Low Tension Glaucoma - diagnosis; Low Tension Glaucoma - physiopathology; Male; Microvascular Density; Middle Aged; Nerve Fibers - pathology; normal tension glaucoma; Optic Disk - blood supply; peripapillary capillary vessel density; Prospective Studies; Retinal Ganglion Cells - pathology; Retinal Vessels - diagnostic imaging; Retinal Vessels - physiopathology; Time Factors; Tomography, Optical Coherence - methods; Visual field; Visual Field Tests; Visual Fields - physiology; glaucoma progression; visual field; normal tension glaucoma; peripapillary capillary vessel density
• ISSN: 1755-375X; 1755-3768; 1755-3768
• DOI: 10.1111/aos.16638

Purpose To explore the association between progressive peripapillary capillary vessel density (pcVD) reduction and the progression of visual field (VF) impairment in individuals with normal tension glaucoma (NTG). Design Prospective cohort study. Methods The study enrolled 110 participants with one eye each, totalling 110 NTG eyes. VF defects were evaluated using standard automated perimetry mean deviation (MD), while pcVD measurements were obtained using optical coherence tomography angiography throughout the follow‐up period. Estimates of VF progression were determined by event‐based and trend‐based analyses. Fast VF progression was defined as an MD slope steeper than −0.5 dB/year, while the slow progression or stable VF was defined as an MD slope better or equal to −0.25 dB/year. Linear mixed‐effects models were employed to analyse the rates of change in pcVD reduction and VF MD decline over time. Additionally, univariable and multivariable linear models were used to examine the relationship between pcVD changes and VF loss rates in NTG. Results Slow VF progression or stable VF was observed in 45% of subjects, while 25% had moderate progression and 30% showed fast progression. Patients with VF progression exhibited faster rate of pcVD reduction in peripapillary global region (−0.73 ± 0.40%/year vs. −0.56 ± 0.35%/year, p = 0.022). Moreover, this rate positively correlated with VF MD decline in NTG (estimate 0.278, 95% CI 0.122–0.433, p = 0.001). Conclusion In individuals with NTG, faster VF progression was linked to a quicker reduction in pcVD, suggesting a positive correlation between pcVD decline and VF deterioration.