The Relationship Between Peripapillary Vascular Density and Visual Field Sensitivity in Primary Open-Angle and...

Area of Science:

• Ophthalmology
• Glaucoma Research
• Vascular Biology

Background:

• Glaucoma is a leading cause of irreversible blindness.
• Understanding the relationship between vascular changes and visual field loss is crucial for glaucoma management.
• Primary open-angle glaucoma (POAG) and primary angle-closure glaucoma (PACG) are distinct subtypes with potentially different pathophysiological mechanisms.

Purpose of the Study:

• To investigate whether the relationship between circumpapillary vascular density (cpVD) and visual field (VF) mean sensitivity (MS) differs between POAG and PACG.
• To compare the association of cpVD with VF MS in different sectors of the optic nerve head.

Main Methods:

• Optical coherence tomography angiography (OCTA) was used to measure cpVD and retinal nerve fiber layer thickness (RNFLT).
• Visual field mean sensitivity (MS) was assessed using standard perimetry.
• Multiple linear regression models were employed to analyze the relationships between cpVD, RNFLT, and VF MS, controlling for covariates like age, intraocular pressure (IOP), and axial length.

Main Results:

• In PACG eyes, cpVD was associated with VF MS in five sectors, while RNFLT was associated in four.
• In POAG eyes, cpVD was associated with VF MS in all measured sectors.
• Higher IOP and lower RNFLT were independently associated with reduced cpVD in PACG, whereas only lower RNFLT was associated with reduced cpVD in POAG.

Conclusions:

• The vascular-function relationship, as determined by OCTA and VF MS, differs significantly between POAG and PACG.
• POAG demonstrates a more consistent association between cpVD and VF MS across all sectors compared to PACG.
• These findings highlight potential differences in the role of vascular compromise in the pathogenesis of POAG and PACG.