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Area of Science:

  • Ophthalmology
  • Neuroscience
  • Medical Imaging

Background:

  • Normal-tension glaucoma (NTG) is a progressive optic neuropathy.
  • Retinal nerve fiber layer (RNFL) thinning is a key indicator of glaucoma progression.
  • Parapapillary choroidal microvasculature dropout (MvD) is a vascular abnormality in the optic nerve head.

Purpose of the Study:

  • To investigate the association between longitudinal changes in peripapillary RNFL thickness and the presence of MvD.
  • To determine if MvD is a predictor of RNFL damage in NTG.

Main Methods:

  • Longitudinal cohort study including 71 eyes of NTG patients.
  • Assessment of MvD using optical coherence tomography (OCT) angiography.
  • Evaluation of RNFL thickness using spectral-domain OCT at baseline and 3-month intervals for at least 18 months.

Main Results:

  • MvD was present in 32.4% of NTG eyes.
  • Eyes with MvD exhibited thinner baseline RNFL and a faster rate of RNFL loss compared to those without MvD.
  • MvD at baseline significantly predicted progressive RNFL loss in both univariate and multivariate analyses.

Conclusions:

  • A significant correlation exists between MvD and decreased RNFL thickness in NTG patients.
  • The presence of MvD serves as a predictor of longitudinal RNFL damage in glaucoma.
  • These findings highlight the role of vascular factors in glaucoma progression.