Relationship Between Parapapillary Microvasculature Dropout and Visual Field Defect in Glaucoma: A Cross-Sectional...

Area of Science:

• Ophthalmology
• Vascular Biology
• Medical Imaging

Background:

• Glaucoma is a leading cause of irreversible blindness globally, driven by optic neuropathy.
• Vascular dysfunction, particularly impaired optic nerve head perfusion, is increasingly implicated in glaucoma.
• Optical coherence tomography angiography (OCTA) allows non-invasive visualization of microvasculature, identifying peripapillary microvasculature dropout (MvD) as a potential glaucoma marker.

Purpose of the Study:

• To investigate the association between peripapillary microvasculature dropout (MvD) and ocular parameters in primary open-angle glaucoma (OAG).
• To evaluate MvD as a potential structural marker for glaucomatous visual field damage.

Main Methods:

• A cross-sectional case-control study involving 41 OAG patients and 46 healthy controls.
• Comprehensive ophthalmic evaluation and OCTA imaging were performed.
• Measurements included peripapillary vessel density (pVD), flow index (pFI), choroidal thickness (PCT), β-zone parapapillary atrophy (β-PPA), and MvD detection.

Main Results:

• Glaucoma patients showed significantly lower pVD, pFI, PCT, and choroidal vascular indices than controls.
• MvD was found in 10 glaucoma eyes and correlated with larger β-PPA, reduced choroidal vascularity, and worse visual field mean deviation (MD).
• MvD demonstrated good discriminatory ability for visual field defects (AUC = 0.77).

Conclusions:

• Peripapillary MvD detected by OCTA is associated with reduced choroidal vascularity and increased β-PPA in glaucoma.
• MvD is linked to greater visual field deterioration, suggesting its potential as a structural marker for glaucoma progression.