Optic Disc Structural Progression in Glaucoma Suspect Eyes With Microvascular Dropout.

Area of Science:

• Ophthalmology
• Glaucoma Research
• Retinal Imaging Analysis

Background:

• Glaucoma suspect eyes require monitoring for structural progression.
• Parapapillary atrophy (PPA) and microvascular changes are potential indicators of glaucoma development.
• Understanding the interplay between structural changes and vascular alterations is crucial for early diagnosis.

Purpose of the Study:

• To investigate the relationship between structural progression, β-zone PPA progression, and microvascular dropout (MvD) in glaucoma suspect eyes.
• To determine if MvD and β-zone PPA progression are independently associated with structural optic disc progression.

Main Methods:

• Retrospective cohort study including eyes with optic disc photographs and OCT angiography (OCTA).
• Structural progression assessed via stereophotographs; β-zone PPA quantified; MvD evaluated using en-face choroidal vessel density maps.
• Multivariable logistic regression and margins analysis used to assess associations.

Main Results:

• 180 eyes from 134 patients were analyzed; 32.2% exhibited MvD.
• Both MvD and β-zone PPA progression were significantly associated with structural progression.
• Eyes with both MvD and β-zone PPA progression showed the highest probability of structural progression (0.75).

Conclusions:

• MvD and β-zone PPA progression are independently associated with structural optic disc progression in glaucoma suspects.
• These changes occurred even in eyes that remained clinically stable without converting to perimetric glaucoma.
• Recognizing these structural changes may facilitate timely management to prevent glaucomatous vision loss.