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Longitudinal Structure-Function Relationship Between Macular Vessel Density and Thickness and Central Visual Field in Early Glaucoma.
Ophthalmology Glaucoma 2022 June 14
PURPOSE: Investigate the relationship of longitudinal changes in macular vessel density (VD) (from optical coherence tomography-angiography-OCTA) and ganglion cell complex (GCC) (from OCT) with central visual field (VF) in early glaucoma eyes.
DESIGN: Observational cohort.
PARTICIPANTS: 95 eyes, 37 preperimetric and 58 early glaucoma (24-2 VF mean deviation (MD)≥-6 dB), with average follow-up of 3.8 years and 5.3 visits were included.
METHODS: Whole image (wiVD and wiGCC) and parafoveal scans, as well as localized regions of interest (LROI), hemiretinas of whole image and superior, inferior, temporal and nasal sectors of parafoveal maps, were matched with central VF locations. Age-adjusted rates of change of VD, GCC, mean sensitivity (MS) of VF locations and 10-2 VF MD were calculated with linear-mixed-effect models. Normalized rates of change were calculated for comparing between change rates in wiVD and wiGCC.
MAIN OUTCOME MEASURE: Structure-function (SF) correlations between VD/GCC and central VF measurement change rates and comparison between the correlations of SF relationships after bootstrapping the difference of the correlations.
RESULTS: VD loss and GCC thinning demonstrated significant correlations with central VF damage, globally and with most LROIs. The SF correlation (r, 95% confidence interval (CI)) was 0.42 (0.24, 0.58) between wiVD and 10-2 VF MD change rates and was 0.27 (0.08, 0.45) between wiGCC and 10-2 VF MD changes rates, all P < 0.05. In contrast to GCC thinning, VD loss in the parafoveal sectors demonstrated significant correlations with central VF damage in inferior and temporal sectors. Differences between the SF relationship with central VF damage was not significant between VD loss and GCC thinning. The mean (95% CI) of normalized change rates of wiVD (-7.40 ((-7.71, -7.09)%/year) was faster than wiGCC (-1.95 ((-2.21, -1.70)%/year), P<0.05.
CONCLUSION: Rates of VD loss and GCC thinning are associated with central VF loss over time. Assessment of both macular VD and GCC thickness should be considered for evaluation of glaucoma progression.
DESIGN: Observational cohort.
PARTICIPANTS: 95 eyes, 37 preperimetric and 58 early glaucoma (24-2 VF mean deviation (MD)≥-6 dB), with average follow-up of 3.8 years and 5.3 visits were included.
METHODS: Whole image (wiVD and wiGCC) and parafoveal scans, as well as localized regions of interest (LROI), hemiretinas of whole image and superior, inferior, temporal and nasal sectors of parafoveal maps, were matched with central VF locations. Age-adjusted rates of change of VD, GCC, mean sensitivity (MS) of VF locations and 10-2 VF MD were calculated with linear-mixed-effect models. Normalized rates of change were calculated for comparing between change rates in wiVD and wiGCC.
MAIN OUTCOME MEASURE: Structure-function (SF) correlations between VD/GCC and central VF measurement change rates and comparison between the correlations of SF relationships after bootstrapping the difference of the correlations.
RESULTS: VD loss and GCC thinning demonstrated significant correlations with central VF damage, globally and with most LROIs. The SF correlation (r, 95% confidence interval (CI)) was 0.42 (0.24, 0.58) between wiVD and 10-2 VF MD change rates and was 0.27 (0.08, 0.45) between wiGCC and 10-2 VF MD changes rates, all P < 0.05. In contrast to GCC thinning, VD loss in the parafoveal sectors demonstrated significant correlations with central VF damage in inferior and temporal sectors. Differences between the SF relationship with central VF damage was not significant between VD loss and GCC thinning. The mean (95% CI) of normalized change rates of wiVD (-7.40 ((-7.71, -7.09)%/year) was faster than wiGCC (-1.95 ((-2.21, -1.70)%/year), P<0.05.
CONCLUSION: Rates of VD loss and GCC thinning are associated with central VF loss over time. Assessment of both macular VD and GCC thickness should be considered for evaluation of glaucoma progression.
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