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Macular Vascular Microcirculation in Eyes With Open-angle Glaucoma Using Different Visual Field Severity

Karine D Bojikian1, Priscilla Nobrega1, Joanne C Wen1

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Summary

Optical coherence tomography angiography (OCTA) reveals differences in macular vascular microcirculation between normal and glaucoma patients. These changes correlate with glaucoma severity, particularly with visual field mean sensitivity (CMS).

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Area of Science:

  • Ophthalmology
  • Medical Imaging
  • Glaucoma Research

Background:

  • Glaucoma is a leading cause of irreversible blindness.
  • Assessing glaucoma severity and progression is crucial for patient management.
  • Optical coherence tomography angiography (OCTA) offers a non-invasive method to visualize ocular microcirculation.

Purpose of the Study:

  • To investigate macular vascular microcirculation differences in normal versus glaucomatous eyes using OCTA.
  • To correlate macular vascular microcirculation metrics with visual field (VF) severity classifications in open-angle glaucoma (OAG) patients.

Main Methods:

  • Swept-source OCTA (Plex Elite 9000) was used to scan 20 normal and 58 OAG eyes.
  • Macular vascular microcirculation was quantified by blood flux index (BFI) and vessel area density (VAD).
  • Glaucoma severity was assessed using four VF classification systems and central 10-degree VF mean sensitivity (CMS).

Main Results:

  • Glaucomatous eyes exhibited significantly lower BFI and VAD in the ganglion cell and inner plexiform layers compared to normal eyes (P<0.0001).
  • OAG patients with mild glaucoma showed significantly higher BFI and VAD than those with severe glaucoma across all VF classifications (P<0.001).
  • Glaucoma Severity Staging and VF CMS demonstrated the strongest correlations with macular vascular microcirculation metrics (r=0.734–0.903).

Conclusions:

  • Macular vascular microcirculation metrics obtained via OCTA are significantly altered in glaucoma and correlate with disease severity.
  • VF CMS, derived from a limited central visual field, shows the highest correlation with macular OCTA findings, suggesting its utility in severity assessment.