Factors contributing to the development of choroidal microvasculature dropout in glaucoma suspects and patients with glaucoma

Abstract

Aims/Purpose: We aimed to characterize and compare the occurrence of MvD between glaucoma suspects and patients with glaucoma. In addition, the factors related to the development of parapapillary MvD in glaucoma suspects and patients with glaucoma were investigated.Methods: Total 150 eyes, 68 eyes of glaucoma suspects and 82 eyes of glaucoma patients were analysed in this study. Disc photography, VF, OCT, HRT, OCTA examinations were performed every year. Student's t‐test and the χ2 test were used to compare continuous and categorical variables, respectively. Slope of OCT, HRT, and VF parameters were calculated as change per year using linear regression. Univariate and multivariate logistic regression analyses were used to identify factors associated with MvD development.Results: Comparison between group who developed MvD and group without MvD, there was a significant difference in the slope of cup volume by OCT, central VF progression, and ONH surface depression measured by HRT. Thinner baseline GCIPL thickness, central VF progression, and the slope of cup shape measures by HRT were found to be significant associated factors to MvD development in multivariate analysis in total subjects. In the regression analysis of glaucoma suspect group, greater axial length and baseline cup volume among the baseline factors and the slope of GCIPL thickness and central VF progression among follow‐up factors were significantly associated with the MvD development. In the glaucoma group, central VF progression and ONH depression among follow‐up elements were observed as significant factors and the baseline factor had little relationship.Conclusions: MvD appears not only as a result of the progression of axonal loss of RGC in glaucoma but may also be developed by structural changes and mechanical susceptibility of the ONH associated with baseline characteristics, including myopia, thin central corneal thickness, and higher baseline IOP. Analysing the structural susceptibility of the ONH can predict the occurrence of MvD, which is can be helpful in predicting the progression of glaucoma.