Baseline choroidal microvasculature dropout as a predictor of rapid global structural loss in open-angle glaucoma

This study included 102 open-angle glaucoma (OAG) eyes with or without a localized choroidal microvasculature dropout (CMvD) at the inferior hemiretina, matched for age (≤ 10 years), axial length (≤ 1 mm), and visual field severity (≤ 1dB), and with a minimum 2-year follow-up. Serial thickness [circumpapillary retinal nerve fiber layer (cpRNFLT) and macular ganglion cell-inner plexiform layer thickness (mGCIPLT)], and vessel density (VD) [circumpapillary (cpVD) and macular VD (mVD)] parameters were obtained. The rate of change in each parameter at both the superior (CMvD-unaffected) and inferior (CMvD-affected) hemiretina were compared between matched eyes with (CMvD+) and without CMvD (CMvD-). Clinical factors associated with the rate of change in each parameter both globally and at the CMvD-unaffected hemiretina were also evaluated. CMvD + eyes showed significantly faster rates of VD and thickness loss at both the CMvD-affected and -unaffected hemiretina. In addition, CMvD was significantly associated with rapid loss of both VD and thickness parameters globally and at the CMvD-unaffected superior hemiretina. In conclusion, OAG eyes with CMvD show significantly faster rates of VD and thickness loss at both the CMvD-affected and unaffected hemiretina. A localized CMvD is an independent predictor of globally rapid structural loss in OAG eyes.