Baseline Vessel Density Parameters for Predicting Visual Field Progression in Open-Angle Glaucoma Eyes With Central...

Area of Science:

• Ophthalmology
• Glaucoma Research
• Vascular Imaging in Eye Disease

Background:

• Open-angle glaucoma (OAG) is a progressive optic neuropathy characterized by visual field (VF) damage.
• Understanding predictors of VF progression is crucial for timely intervention in OAG patients.
• Vessel density (VD) parameters, particularly parapapillary choroidal vessel density (pCVD) and macular ganglion cell-inner plexiform layer (mGCIPL) thickness, are potential biomarkers.

Purpose of the Study:

• To identify baseline vessel density (VD) parameters that predict visual field (VF) progression in patients with open-angle glaucoma (OAG) and central visual field (CVF) damage.
• To evaluate the association between baseline pCVD and mGCIPL thickness with VF progression across different glaucoma stages.

Main Methods:

• Retrospective cohort study of 208 eyes from patients with OAG and CVF damage, followed for at least 2 years.
• Optical coherence tomography (OCT) angiography was used to measure baseline circumpapillary, macular, and parapapillary choroidal vessel density (pCVD).
• Baseline circumpapillary retinal nerve fiber layer (cpRNFL) and macular ganglion cell-inner plexiform layer (mGCIPL) thicknesses were measured; Cox proportional hazard analysis identified predictors of VF progression.

Main Results:

• Visual field progression occurred in 26.0% of eyes over a mean follow-up of 2.78 years.
• A lower baseline pCVD was an independent predictor of VF progression in early-stage OAG (hazard ratio = 0.916, P = .014).
• Reduced baseline average mGCIPL thickness predicted VF progression in moderate to advanced glaucoma (hazard ratio = 0.896, P = .001).

Conclusions:

• In OAG patients with CVF damage, baseline pCVD is a significant predictor of subsequent VF progression in early stages.
• Reduced baseline mGCIPL thickness is a significant predictor of VF progression in moderate to advanced glaucoma.
• These findings highlight the importance of vascular and inner retinal parameters in predicting glaucoma progression.