|Vessel density parameters can be helpful in predicting visual field progression in OAG eyes. Click image to enlarge.|
In an effort to identify baseline vessel density (VD) parameters that increase the risk of visual field (VF) progression in open-angle glaucoma (OAG) patients with central visual field (VF) damage, researchers recently found that a lower baseline parapapillary choroidal VD (pCVD) in early-stage glaucoma and a reduced baseline macular ganglion cell-inner plexiform layer (mGCIPL) thicknesses in moderate to advanced glaucoma are both significantly associated with subsequent VF progression.
This retrospective cohort study enrolled 208 eyes from 208 consecutive OAG patients with central VF damage at baseline and a minimum of two years of follow-up. Optical coherence tomography angiography was used to measure circumpapillary and macular VDs in the retina and pCVD at baseline. The cpRNFL and mGCIPL thicknesses were also measured as reference standards. Cox proportional hazard analysis was performed to identify the baseline clinical factors associated with VF progression according to glaucoma stage. The relationships between the central VF mean sensitivity reduction rate during follow-up and the baseline clinical factors were then evaluated.
VF progression was detected in 54 eyes (26%) during 2.78 years of mean follow-up. A lower pCVD at baseline in early-stage OAG eyes and a reduced baseline average mGCIPL thickness in eyes with moderate to advanced glaucoma were independent predictors of VF progression. The baseline pCVD in eyes with early-stage glaucoma and the baseline average mGCIPL thickness in eyes with moderate to advanced glaucoma were significantly correlated with the rate (dB/year) of central VF mean sensitivity reduction.
“We have here identified the baseline vascular and structural parameters that can predict VF progression in OAG eyes with central VF damage at different stages of glaucoma,” the study authors concluded in their paper.
Lee JY, Shin JW, Song MK, et al. Baseline vessel density parameters for predicting visual field progression in open-angle glaucoma eyes with central visual field damage. Am J Ophthalmol. December 10, 2021. [Epub ahead of print].