Association of Retinal Blood Flow with Progression of Visual Field in Glaucoma

In the glaucoma clinic, patients with normal intraocular pressure (IOP) can sometimes show visual field (VF) progression. Therefore, clarification of relationship between vascular status and glaucomatous VF deterioration is a focus of interest. We used optical coherence tomography angiography (OCTA), with the aim of evaluating the relationship between vessel density (VD) and VF progression in glaucoma patients. We included 104 eyes with open angle glaucoma who were followed up for at least 5 years in this retrospective case-control study. Superficial and deep VD of macula were assessed by OCTA. Regression analysis and Cox proportional hazards model were used to identify factors significantly associated with VF progression. In logistic regression analysis determining VF progression from Guided Progression Analysis (GPA) program, initial IOP and deep macular VD were significantly associated with VF progression in multivariate analysis (P = 0.019 and 0.004). Cox proportional hazards model also identified deep macular VD as significantly related to VF progression (P = 0.035). In conclusion, initial IOP and deep VD were related to VF deterioration in glaucoma. Deep VD might be used as a surrogate of glaucomatous VF progression related with vascular incompetence.