Optic Disc Microvasculature Reduction and Visual Field Progression in Advanced Primary Open-Angle Glaucoma

Area of Science:

• Ophthalmology
• Medical Imaging
• Glaucoma Research

Background:

• Primary open-angle glaucoma (POAG) is a leading cause of irreversible blindness.
• Monitoring disease progression is crucial for effective management.
• Optic disc vessel density (ODVD) is a potential biomarker for glaucoma progression.

Purpose of the Study:

• To investigate the association between optic disc vessel density (ODVD) reduction and visual field (VF) progression in POAG patients.
• To analyze this relationship based on glaucoma severity (early, moderate, advanced).

Main Methods:

• Retrospective case series of 345 POAG patients.
• Categorization into early, moderate, and advanced stages based on VF mean deviation.
• Analysis of optical coherence tomography angiography (OCTA) for ODVD and visual fields (VFs) over at least 3 years.
• Statistical models (logistic and Cox PH) assessed the link between ODVD change rate and VF progression.

Main Results:

• Significantly faster ODVD reduction rates were observed in VF progressors across all severity groups (P < 0.001).
• Both the rate of global ODVD change and binary ODVD reduction were significantly associated with VF progression in multivariable logistic regression (all P < 0.05).
• Cox PH models confirmed a significant association between ODVD changes and VF progression in early and moderate-to-advanced glaucoma (all P < 0.001).

Conclusions:

• Reduction in optic disc microvasculature is a valuable marker for detecting glaucoma progression.
• This finding applies to patients across all stages of glaucoma, including early, moderate, and advanced.
• ODVD changes can aid in monitoring disease advancement in POAG.