Progressive Macular Vessel Density Loss Observed on Optical Coherence Tomography Angiography in Glaucoma Patients With Single-Hemifield Visual Field Defects

Abstract

Précis: Faster hemispheric mVD loss was found in the affected hemifield of POAG patients without significant changes in hemispheric thickness. The progression of mVD loss was associated with the severity of VF damage. Purpose: To evaluate the changes in macular vessel density (mVD) loss in primary open angle glaucoma (POAG) patients with visual field (VF) defects confined to 1 hemifield. Materials and Methods: This longitudinal cohort study used linear mixed models to evaluate the changes in the hemispheric mean total deviation (mTD), mVD, macular ganglion cell complex, macular ganglion cell-inner plexiform layer, and retinal nerve fiber layer between affected hemifields, unaffected hemifields, and healthy controls. Results: Twenty-nine POAG eyes and 25 healthy eyes were followed for an average of 29 months. In POAG eyes, the rates of decline in hemispheric mTD and hemispheric mVD in the affected hemifields were significantly faster than those in the unaffected hemifields (−0.42±1.24 vs. 0.02±0.69 dB/year, P=0.018 and −2.16±1.01 vs. −1.77±0.90% / year, P=0.031, respectively). There were no differences in the rate of hemispheric thickness change between the 2 hemifields. The rate of hemispheric mVD decline in both hemifields of POAG eyes was significantly faster than that of the healthy controls (All P<0.05). An association between the reduced mTD of the VF and the rate of hemispheric mVD loss in the affected hemifield was observed (r=0.484, P=0.008). Faster rates of mVD loss (β=−1.72±0.80, P =0.050) were significantly related to reduced hemispheric mTD in the multivariate analysis. Conclusions: Faster hemispheric mVD loss was found in the affected hemifield of POAG patients without significant changes in hemispheric thickness. The progression of mVD loss was associated with the severity of VF damage.