Abstract
Central visual field (CVF) loss is important in maintaining vision-related quality of life in eyes with open-angle glaucoma (OAG). The present study investigated whether nasalized location of central retinal vessel trunk (CRVT) at baseline is associated with rapid rate of CVF loss in early-stage OAG eyes. This study included 76 OAG eyes with high nasalization CRVT [HNL] group and 75 OAG eyes with low nasalization CRVT [LNL] group matched for glaucoma severity at baseline that showed progressive visual field (VF) loss. The rates of mean threshold changes at various regions were compared in the two groups using a linear mixed model. Clinical variables associated with rapid rate of CVF progression were also identified using a linear mixed model. The rate of CVF loss in the central 10° was significantly higher in the HNL group than that in the LNL group (−0.452 dB/year vs. −0.291 dB/year, P < 0.001). The average and inferior hemi-macular ganglion cell inner plexiform layer (GCIPL) progression rates were significantly faster in the HNL group than in the LNL group (P < 0.05). Nasalized location of CRVT was an independent predictor of a more rapid VF loss in the central 10° region (P < 0.05).
Highlights
The central visual field (CVF), which includes the 12 central-most points on standard 24–2 visual field (VF) testing, is strongly associated with activities of daily living, including “reading and seeing detail”[1,2]
Previous cross-sectional studies have reported that nasalized central retinal vessel trunk (CRVT) is consistently associated with Central visual field (CVF) defects in glaucomatous eyes regardless of disease severity[13,14]
CRVT may act as a stabilization support preventing glaucomatous deformation in the lamina cribrosa (LC)
Summary
The central visual field (CVF), which includes the 12 central-most points on standard 24–2 visual field (VF) testing, is strongly associated with activities of daily living, including “reading and seeing detail”[1,2]. There would be clinical benefit in predicting CVF loss in the early stages of glaucoma, especially in eyes with progressive VF loss[2,3]. The location of the central retinal vessel trunk (CRVT), which marks the exit position of the retinal vessels on the ONH, has been known to be associated with relative protection of nearest part of the neuroretinal rim tissue; the further away the region from the CRVT, the more likely it is affected by neuroretinal rim loss in glaucoma[8]. Nasalization of the CRVT was frequently found in OAG eyes with CVF loss at initial presentation regardless of glaucoma severity[13,14]. To the best of our knowledge, no reports in the ophthalmic literature have evaluated whether a nasalized CRVT is associated with a more rapid VF loss at a specific location (i.e., the CVF region) over time in OAG patients. The association between various clinical variables, including CRVT location, and rapid CVF progression was assessed
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