Retinal Vessel Density and Visual Field Changes and Their Correlation Following the Deep Sclerotomy in Primary Open-angle Glaucoma

Abstract

Abstract Purpose To explore any role of the Mitomycin-augmented Non-penetrating Deep Sclerotomy (NPDS) procedure on the retinal microvasculature and visual field and their correlation in POAG eyes. Methods 22 POAG eyes of 22 patients without previous surgical interventions for glaucoma, whose disease was progressing and/or the intraocular pressure was not at the target level with full topical medication, were allocated to this prospective interventional study. All the patients underwent the non-penetrating deep sclerotomy procedure and followed up for a month. The IOP, Humphery Visual Field (HVF) 30 − 2, RNFL, and the vessel density (VD) of the optic nerve head and macula (by OCTA) were evaluated one day before the surgery and one month after the NPDS procedure. Results At the one-month post-op follow-up, the IOP was significantly decreased compared to the pre-op visit (8mmHg vs. 23.5mmHg, p: <0.001). The visual field MD significantly improved one month after the NPDS procedure (-13.06dB vs. -15.44dB, p:0.038), although the PSD did not indicate any significant change. Neither the peripapillary nor the macular VD significantly changed during the study. However, the MD was significantly and positively correlated to the whole image, peripapillary, perifoveal, and parafoveal VD. Conclusion The deep sclerotomy procedure is a compelling choice of POAG treatment, which could significantly decrease the IOP and improve the visual field. However, this procedure may not alter the retinal microvasculature in a short period. Nevertheless, the positive correlation between retinal VD and the visual field MD proposes a possible vascular mechanism for the visual field defect in glaucomatous eyes.