Optic Disc Microvasculature Dropout in Preperimetric Glaucoma

Area of Science:

• Ophthalmology
• Glaucoma Research
• Microvascular Imaging

Background:

• Preperimetric primary open-angle glaucoma (PPG) presents diagnostic challenges.
• Optic disc microvasculature dropout (MvD-D) is a potential indicator of glaucomatous damage.
• Understanding MvD-D's association with other glaucoma parameters is crucial for early detection.

Purpose of the Study:

• To identify factors associated with optic disc microvasculature dropout (MvD-D) in patients with preperimetric primary open-angle glaucoma (PPG).

Main Methods:

• Optical coherence tomography angiography (OCTA) was used to detect MvD-D in 139 PPG eyes.
• Factors analyzed included visual field mean deviation (MD), RNFL thickness, lamina cribrosa (LC) defects, optic disc hemorrhage, and parapapillary MvD-P.
• Comparison was made between eyes with and without MvD-D.

Main Results:

• MvD-D was present in 49.6% of PPG eyes.
• Eyes with MvD-D showed thinner RNFL, worse VF MD, and higher prevalence of focal LC defect and MvD-P compared to those without.
• Male gender, worse VF MD, thinner global RNFL, focal LC defect, and MvD-P were significantly associated with MvD-D in multivariable analysis.

Conclusions:

• Optic disc microvasculature dropout (MvD-D) is associated with worse disease severity in PPG.
• MvD-D frequently occurs without focal lamina cribrosa defects or parapapillary microvasculature dropout.
• Impaired optic disc circulation may be an early glaucoma sign preceding functional or structural changes.