Structural, Vascular, and Functional Correlations in Advanced Glaucoma

To evaluate the correlation between structural tests - optical coherence tomography (OCT) and OCT angiography (OCTA) - and the functional visual field test (VFT) in patients with advanced-stage glaucoma.

This retrospective observational study included patients with a mean deviation (MD) worse than -12 dB on the 24-2 VFT. Patients with a history of intraocular surgery within the previous 6 months or with unreliable OCT, OCTA, or VFT results were excluded. For each patient, best-corrected visual acuity (BCVA), retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) thickness (via OCT), radial peripapillary capillary vessel density (VD) of the optic disc, and superficial/deep macular VD (via OCTA) were assessed. Functional parameters included MD and pattern standard deviation from VFT. Correlations between structural and functional parameters were analyzed.

The study included 31 eyes of 20 patients (mean age: 68.81 ± 8.19 years; 65% male). Diagnoses per eye were pseudoexfoliative glaucoma (n = 14), primary open-angle glaucoma (n = 11), normal-tension glaucoma (n = 4), and pigmentary glaucoma (n = 2). The mean MD was -16.78 ± 7.46 dB. Moderate correlations were found between RNFL and GCC thicknesses, peripapillary and macular VD, and visual field indices. BCVA was also correlated with superior RNFL, GCC, and OCTA values.

Significant correlations exist between structural and functional tests in advanced glaucoma. Combined use of OCT, OCTA, and VFT provides a more holistic and effective approach in disease monitoring and management.