Association of macular vessel density and ganglion cell complex thickness with central visual field progression in...

To evaluate the association of macular vessel density (VD) and ganglion cell complex (GCC) thickness with 10-2 central visual field (CVF) progression in glaucoma.

In this retrospective cohort study, patients with glaucoma from Diagnostic Innovation in Glaucoma Study with≥five 10-2 visual field (VF) tests and 3-year follow-up before optical coherence tomography (OCT) and OCT angiography (OCTA) imaging were included. Whole-image GCC thickness (wiGCC) and superficial VD (wiVD) were obtained from 6*6 macula scans. The association of wiVD and wiGCC with past rate of 10-2 VF mean deviation worsening, and with past CVF progression (defined using clustered linear regression criteria) was evaluated using linear mixed models after adjusting for confounders.

From 238 eyes (141 patients), 25 eyes (11%) of 16 patients were CVF progressors. In the multivariable analysis of the association between OCT/OCTA parameters and past rate of 10-2 CVF worsening, lower wiVD (β=-0.04 (-0.05, -0.02); p<0.001; R²=0.32) and wiGCC (β=-0.01 (-0.01, 0.00); p=0.004; R²=0.21) were significantly associated with faster CVF worsening. For the association between OCT/OCTA parameters and past CVF progression, the multivariable analysis showed that a lower wiVD was significantly associated with increased odds of past CVF progression (OR=1.23 (1.06, 1.44) per 1% lower; p=0.008), while wiGCC did not show correlation.

Lower macular VD and GCC were associated with faster worsening of CVF, and lower macular VD was associated with increased odds of CVF progression. Assessment of macular OCT and OCTA may help detect glaucoma eyes with CVF progression.