Superficial macular vessel density (VD) is more strongly correlated with central visual field sensitivity (cVFS) than other structural parameters, suggesting that it is possible to assess structural defects in patients with advanced glaucoma using visual field testing, according to research published in Ophthalmology Glaucoma.
Researchers conducted a cross-sectional study to evaluate the global and regional relationships between structural parameters and cVFS in patients with advanced glaucoma.
The team measured structural parameters using spectral-domain optical coherence tomography (OCT) and angiography, including the retinal nerve fiber layer (RNFL), ganglion cell complex (GCC), peripapillary vessel density, and superficial and deep macular VD (mVD). They assessed cVFS via the mean deviation on the 10-2 visual field [VF] test (MD10) and the mean deviation of the central 16 points on the 10-2 VF test (MD16).
A total of 226 eyes of 226 patients (mean age, 60.0±13.5 years; 61.5% men and 38.5% women) with advanced glaucoma were included in the study and classified into 2 groups, one with minor central defect (defined as MD10 >-10 decibels [dB]) and one with significant central defect (defined as MD10 ≤-10 dB).
In the minor central defect group, the researchers found the strongest correlations between MD16 and the superficial macular vessel density and parafoveal macular vessel density (r=0.52 and r=0.54, respectively; P <.001 for both) followed by the deep macular vessel density (r=0.40; P =.002).
In the significant central defect group, they found the strongest correlations between MD10 and the superficial macular vessel density (r=0.47; P <.001) and the superficial parafoveal macular vessel density (r=0.43; P <.001).
When analyzing the relationship between superficial macular vessel density and cVFS using segmented regression, the researchers identified a breakpoint at -5.95 dB for MD16 (P <.001) but no breakpoint for MD10.
They also identified significant regional correlations between the grid vessel density and sectors of the central 16 points, with r ranging from 0.20 to 0.53 (P =.010 to P <.001).
“We found that peripapillary VD had a better correlation with cVFS than the thicknesses of the RNFL and GCC in the significant central defect group,” the researchers report. “In conclusion, superficial macular VD was shown to be suitable for the assessment of central VF defect in patients with advanced glaucoma. It displayed a better correlation with cVFS than the RNFL thickness, GCC thickness, and peripapillary VD.”
Limitations of the study included the cross-sectional design and potential false positives in the VF tests.
Hsia Y, Wang TH, Huang JY, Su CC. Relationship between the macular microvasculature and central visual field sensitivity in patients with advanced glaucoma. Ophthalmol Glaucoma. Published online February 15, 2023. doi:10.1016/j.ogla.2023.02.002