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Influence of Refractive Error on Circumpapillary Structure-Function Versus Vessel Density-Function Relationships in
Yoshinobu Emoto1, Gábor Hollό2,3, Yoshiyuki Kita1
1Department of Ophthalmology, Kyorin University School of Medicine, Tokyo, Japan.
Journal of Glaucoma
|June 14, 2023
Summary
In Japanese open angle glaucoma (OAG) patients, circumpapillary vessel density (cpVD) shows a stronger correlation with visual field parameters (MD and VFI) than retinal nerve fiber layer thickness (RNFLT). This relationship is maintained across all refractive error categories, including high myopia.
Area of Science:
- Ophthalmology
- Glaucoma Research
- Optical Coherence Tomography Imaging
Background:
- Open angle glaucoma (OAG) is a leading cause of irreversible blindness.
- Assessing the relationship between structural and functional parameters is crucial for understanding glaucoma progression.
- Refractive error can influence measurements of ocular structures and visual fields.
Purpose of the Study:
- To investigate how refractive error affects the association between circumpapillary retinal nerve fiber layer thickness (cpRNFLT) and circumpapillary vessel density (cpVD) with visual field parameters in Japanese OAG eyes.
- To compare the strength of correlation between cpRNFLT and cpVD with visual field indices across different refractive error groups.
Main Methods:
- A cross-sectional study involving 81 Japanese OAG patients with refractive errors ranging from +3.0 to -9.0 D.
- 360-degree cpRNFLT and cpVD measurements were obtained using Cirrus HD 5000-AngioPlex OCT.
- 30-2 Humphrey visual field testing was performed to assess mean deviation (MD) and visual field index (VFI).
Main Results:
- Strong correlations were observed between visual field parameters (MD, VFI) and both cpRNFLT and cpVD in the total population, with cpVD showing higher correlation coefficients (r=0.722 for cpVD vs. r=0.532 for cpRNFLT).
- Correlations between cpRNFLT and visual field parameters were significant only in emmetropia/hyperopia and moderate myopia groups.
- Significant and strong correlations between cpVD and visual field parameters were consistently found across all refractive subgroups, including high myopia (r-values ranging from 0.548 to 0.841).
Conclusions:
- Circumpapillary vessel density (cpVD) demonstrates a robust and systematically stronger correlation with visual field parameters (MD and VFI) compared to circumpapillary retinal nerve fiber layer thickness (cpRNFLT) in Japanese OAG eyes.
- The strong association between cpVD and visual function is preserved across all refractive error categories, notably including high myopia.
- cpVD may serve as a valuable biomarker for assessing glaucomatous visual field loss, even in the presence of significant refractive errors.
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