Focal Structure–Function Relationships in Primary Open-Angle Glaucoma Using OCT and OCT-A Measurements

• Published in: Investigative ophthalmology & visual science Vol. 61; no. 14; p. 33
• Main Authors: Wong, Damon, Chua, Jacqueline, Lin, Emily, Tan, Bingyao, Yao, Xinwen, Chong, Rachel, Sng, Chelvin, Lau, Amanda, Husain, Rahat, Aung, Tin, Schmetterer, Leopold
• Format: Journal Article
• Language: English
• Published: United States The Association for Research in Vision and Ophthalmology 01.12.2020
• Subjects: Aged; Female; Fovea Centralis - diagnostic imaging; Fovea Centralis - pathology; Glaucoma; Glaucoma, Open-Angle - diagnostic imaging; Glaucoma, Open-Angle - pathology; Humans; Intraocular Pressure; Male; Refractive Errors - diagnostic imaging; Refractive Errors - pathology; Retina - diagnostic imaging; Retina - pathology; Tomography, Optical Coherence; Visual Fields
• ISSN: 1552-5783; 0146-0404; 1552-5783
• DOI: 10.1167/iovs.61.14.33

To evaluate the focal structure-function associations among visual field (VF) loss, optical coherence tomography angiography (OCT-A) vascular measurements, and optical coherence tomography (OCT) structural measurements in glaucoma. In this cross-sectional study, subjects underwent standard automated perimetry, OCT-based nerve fiber thickness measurements, and OCT-A imaging. Mappings of focal VF test locations with OCT and OCT-A measurements were defined using anatomically adjusted nerve fiber trajectories and were studied using multivariate mixed-effects analysis. Segmented regression analysis was used to determine the presence of breakpoints in the structure-function associations. The study included 119 eyes from 86 Chinese subjects with primary open-angle glaucoma (POAG). VF mean deviation was significantly associated with global capillary perfusion density (β = 0.13 ± 0.08) and global retinal nerve fiber layer thickness (β = 0.09 ± 0.02). Focal capillary density (FCD) was significantly associated with VF losses at 34 VF test locations (66.7% of 24-2 VF), with 24 of the 34 locations being within 20° of retinal eccentricity. Focal nerve layer (FNL) thickness was significantly associated with 16 VF test locations (31.4% of 24-2 VF; eight locations within 20° eccentricity). For VF test locations in the central 10° VF, VF losses below the breakpoint were significantly associated with FCD (slope, 0.89 ± 0.12, P < 0.001), but not with FNL thickness (slope, 0.57 ± 0.39, P = 0.15). Focal capillary densities were significantly associated with a wider range of visual field losses and in a larger proportion of the visual field compared to nerve fiber thickness.