Factors Associated with Visual Acuity in Advanced Glaucoma

This study aimed to comprehensively analyze various parameters in advanced glaucoma patients to identify the factors that can affect best-corrected visual acuity (BCVA) in advanced glaucoma. This cross-sectional retrospective study included 113 patients (mean age, 61.66 ± 13.26 years; males, 67) who had advanced glaucomatous damage (113 eyes; mean BCVA, 0.18 ± 0.38 logMAR; mean deviation of 30-2 visual field [VF], -19.08 ± 6.23 dB). Peripapillary retinal nerve fiber layer (RNFL) and total and segmented macular thickness (RNFL, ganglion cell layer (GCL), and inner plexiform layer (GCL)) were measured using Spectralis optical coherence tomography (OCT). Correlations between BCVA and OCT parameters or 30-2 VF parameters were assessed using Pearson correlation analysis. Multivariate regression analysis was performed to determine the factors associated with BCVA in advanced glaucoma patients. Peripapillary RNFL thickness, subfoveal choroidal thickness, and global macular RNFL, GCL, IPL, and total thickness were found to be significantly correlated with BCVA and central visual function. Multivariate analysis showed a significant correlation between subfoveal choroidal thickness and BCVA. In addition, central VF mean sensitivity, especially inferior hemifield, showed a significant relationship with BCVA. In conclusion, subfoveal choroidal thickness and central VF sensitivity, especially the inferior hemifield area, are factors that affect BCVA in advanced glaucoma.