Comparison of vascular-function and structure-function correlations in glaucomatous eyes with high myopia

Area of Science:

• Ophthalmology
• Medical Imaging
• Glaucoma Research

Background:

• Primary open-angle glaucoma (POAG) poses diagnostic challenges in highly myopic eyes.
• Optical coherence tomography (OCT) scans can exhibit segmentation errors (SE) in these eyes, complicating analysis.
• Peripapillary retinal vessel density (VD) is a potential biomarker for glaucomatous damage.

Purpose of the Study:

• To evaluate the utility of peripapillary retinal vessel density (VD) measured by optical coherence tomography angiography (OCTA).
• To assess glaucomatous visual field damage in highly myopic eyes with primary open-angle glaucoma (POAG).
• To determine if OCTA is useful despite segmentation errors in OCT scans.

Main Methods:

• A cross-sectional observational study included 124 myopic POAG eyes (40 with SE, 84 without SE).
• Peripapillary retinal VD was measured using OCTA.
• Circumpapillary retinal nerve fibre layer thickness (RNFLT) and visual field sensitivity loss (VFSL) were assessed using spectral-domain OCT and standard automated perimetry, respectively.

Main Results:

• Peripapillary retinal VD showed significant topographical correlation with VFSL in highly myopic POAG eyes, both globally and in specific sectors.
• This correlation was observed regardless of the presence of segmentation errors (SE) in OCT scans.
• The correlation between VD and VFSL was comparable to that of RNFLT and VFSL in eyes without SE.

Conclusions:

• Peripapillary VD measured by OCTA correlates topographically with VFSL in highly myopic POAG eyes.
• OCTA is a valuable tool for evaluating glaucomatous visual field damage in high myopia, even with confounding OCT segmentation errors.
• OCTA can serve as a useful adjunct in managing glaucoma in complex cases with high myopia.