Relationship between the Macular Microvasculature and Central Visual Field Sensitivity in Patients with Advanced Glaucoma

Yun Hsia; Tsing-Hong Wang; Jehn-Yu Huang; Chien-Chia Su

doi:10.1016/j.ogla.2023.02.002

Relationship between the Macular Microvasculature and Central Visual Field Sensitivity in Patients with Advanced Glaucoma

Ophthalmol Glaucoma. 2023 Jul-Aug;6(4):413-421. doi: 10.1016/j.ogla.2023.02.002. Epub 2023 Feb 15.

Authors

Yun Hsia¹, Tsing-Hong Wang², Jehn-Yu Huang², Chien-Chia Su³

Affiliations

¹ Department of Ophthalmology, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan; Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan.
² Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan; College of Medicine, National Taiwan University, Taipei, Taiwan.
³ Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan; College of Medicine, National Taiwan University, Taipei, Taiwan. Electronic address: chienchiasu@ntu.edu.tw.

PMID: 36801261
DOI: 10.1016/j.ogla.2023.02.002

Abstract

Purpose: To evaluate the relationship between central visual field sensitivity (cVFS) and the structural parameters in patients with advanced glaucoma.

Design: Cross-sectional study.

Methods: In total, 226 eyes of 226 patients with advanced glaucoma were classified into the "minor central defect" (mean deviation on 10-2 visual field test [MD10] > -10 dB) and "significant central defect" (MD10 ≤ -10 dB) groups. We examined the structural parameters using RTVue OCT and angiography, including the retinal nerve fiber layer, ganglion cell complex, peripapillary vessel density (VD), and superficial and deep macular VD (mVD). The assessment of cVFS included MD10 and the mean deviation of the central 16 points on the 10-2 VF test (MD16). We used Pearson correlation and segmented regression to assess the global and regional relationships between the structural parameters and cVFS.

Main outcome measures: Correlation between structural parameters and cVFS.

Results: In the minor central defect group, the best global correlations existed between the superficial macular and parafoveal mVD and MD16 (r = 0.52 and 0.54, P < 0.001). In the significant central defect group, superficial mVD best correlated with MD10 (r = 0.47, P < 0.001). Segmented regression between superficial mVD and cVFS revealed no breakpoint was found as MD10 declined, but a breakpoint was identified at -5.95 dB for MD16, which was statistically significant (P < 0.001). The regional correlations between the grid VD and sectors of the central 16 points were significant (r = 0.20-0.53, P= 0.010 ∼P < 0.001).

Conclusions: The fair global and regional relationships between mVD and cVFS suggest that mVD may be beneficial for monitoring cVFS in patients with advanced glaucoma.

Financial disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Keywords: Advanced glaucoma; Central visual field sensitivity; Macular microvasculature; OCT angiography.

MeSH terms

Cross-Sectional Studies
Glaucoma* / complications
Glaucoma* / diagnosis
Glaucoma, Open-Angle*
Humans
Intraocular Pressure
Microvessels
Optic Disk* / blood supply
Retinal Ganglion Cells
Retinal Vessels
Visual Field Tests
Visual Fields