Association of Macular and Circumpapillary Microvasculature with Visual Field Sensitivity in Advanced Glaucoma

Abstract

To evaluate the association between optical coherence tomography angiography (OCTA) macular and circumpapillary vessel density and visual field mean deviation (MD) in advanced primary open angle glaucoma. Cross-sectional study. Macula (superficial layer) and optic nerve head (ONH) with capillary density (CD) and without vessel density (VD) automated removal of large vessels OCTA of 34 eyes (34 patients, MD < -10 dB) were investigated as macula whole image VD (wiVD), parafoveal VD (pfVD), ONH wiVD, wiCD, circumpapillary VD, and cpCD. Spectral domain OCT circumpapillary retinal nerve fiber layer, macular ganglion cell complex, and ganglion cell inner plexiform layer were also analyzed. Macular and ONH VD decreased significantly with worsening MD. Each 1-dB decrease in MD was associated with a reduction of 0.43% and 0.46% for macular wiVD and pfVD with R2 of 0.28 and 0.27, respectively (all P < .01). The association between MD and VD was strongest for measures of ONH with large vessels removed, wiCD, and cpCD, followed by wiVD and circumpapillary VD with R2 of 0.26, 0.22, 0.17, 0.14, and a VD reduction of 0.43%, 0.51%, 0.33%, and 0.40%, respectively (all P < .02). There was a reduction of 1.19μm in Avanti parafoveal ganglion cell complex, 1.13μm in Spectralis ganglion cell inner plexiform layer, and 1.01μm in Spectralis circumpapillary retinal nerve fiber layer, with R2 of 0.19 (P= .006), 0.23 (P= .002), and 0.24 (P= .002), respectively. ONH and macula OCTA VD and thickness are associated with the severity of visual field damage in advanced primary open angle glaucoma.