Structural and vascular changes in glaucoma with single-hemifield defect: predictors of opposite hemifield visual...

Area of Science:

• Ophthalmology
• Glaucoma Research
• Retinal Imaging Analysis

Background:

• Primary open-angle glaucoma (POAG) can progress to affect both visual fields (VF).
• Early detection of progression in unaffected areas is crucial for timely intervention.
• Longitudinal changes in vascular and structural parameters may indicate future VF loss.

Purpose of the Study:

• To investigate longitudinal changes in optic nerve head (ONH) superficial vessel density (VD), macular VD, circumpapillary retinal nerve fiber layer (RNFL) thickness, and macular ganglion cell-inner plexiform layer (GCIPL) thickness.
• To assess the association of these changes with future VF defects in the unaffected hemifields of POAG eyes with existing single-hemifield defects.

Main Methods:

• Retrospective observational study of 61 POAG eyes with single-hemifield VF defects.
• Follow-up of 2.7 years to monitor for VF defect development in the opposite hemifield.
• Comparison of longitudinal VD and structural parameter changes between 'conversion' and 'no conversion' groups using Cox proportional hazard models.

Main Results:

• 17 eyes (27.9%) showed conversion to a new VF defect.
• The conversion group had significantly greater rates of VD and structural changes in both hemiretinas.
• Increased rates of change in GCIPL thickness, ONH superficial VD, macular VD, and RNFL thickness were risk factors for VF conversion.

Conclusions:

• Progressive changes in vessel density and structural parameters are significant predictors of future VF defects in the contralateral hemifield.
• Monitoring these longitudinal changes can aid in predicting POAG progression in eyes with initial single-hemifield defects.