Relationship Between Central Retinal Vessel Trunk Location and Visual Field Loss in Glaucoma

Area of Science:

• Ophthalmology
• Optometry
• Medical Imaging

Background:

• Glaucoma is a leading cause of irreversible blindness.
• Early detection and monitoring of glaucoma progression are crucial for vision preservation.
• Understanding the structural basis of visual field loss is key to improving diagnostic tools.

Purpose of the Study:

• To investigate the association between the location of the horizontal central retinal vessel trunk (CRVTL) on optic discs and sector-specific visual field (VF) loss in glaucoma patients.
• To determine if CRVTL location can serve as a biomarker for central VF defects.

Main Methods:

• A retrospective cross-sectional study involving 421 eyes of 421 glaucoma patients.
• Manual tracking of CRVTL on fundus images and extraction of circumpapillary retinal nerve fiber layer thickness (cpRNFLT) using optical coherence tomography (OCT).
• Linear regression models were used to analyze the relationship between CRVTL, cpRNFLT, and sector-specific VF loss, stratified by glaucoma severity (mild, moderate, severe).

Main Results:

• CRVTL nasalization showed a significant correlation exclusively with central VF loss across different glaucoma severities (P < .001).
• Focal cpRNFLT also correlated with respective VF sectors, but multivariate models combining cpRNFLT and CRVTL significantly improved structure-function correlation (P < .001).
• The correlation between CRVTL and central VF loss strengthened with increasing glaucoma severity.

Conclusions:

• Horizontal CRVTL nasalization is a significant and independent predictor of central VF loss in glaucoma, irrespective of cpRNFLT.
• CRVTL may represent a novel structural biomarker for identifying and monitoring central visual field deficits in glaucoma patients.