Decreased Visual Acuity Accompanied with Central Scotomas in Normal Tension Glaucoma: Macular Optical Coherence Tomography Angiography Cases

Abstract

Purpose: To report two cases of decreased visual acuity (VA) accompanied with central scotomas in normal tension glaucoma (NTG) patients investigated with macular optical coherence tomography (OCT) angiography between the eye with decreased VA and the fellow eye.Case summary: A 64-year-old male visited with decreased VA in the right eye as best corrected VA of (0.5). On OCT Angiography, macular vessel density (VD) from superficial layer was smaller in the right eye than the fellow eye as 56.03 and 88.15 (optical density), respectively. Macular VD from deep layer was similar between the two eyes as 116.33 and 113.35 (optical density), respectively. A 52-year-old male presented with decreased VA in the left eye as best corrected VA of (0.5). Macular VD from superficial layer was smaller in the left eye than the fellow eye as 115.55 (optical density) and 131.28 (optical density). VD from deep layer did not show much difference, which was 118.16 and 125.17 (optical density), respectively. On both cases no specific finding was observed at macula on funduscopy or macular OCT. Central scotomas on visual fields and findings of NTG were observed.Conclusions: In these two patients with decreased VA accompanied with NTG and central scotomas, macular VD from superficial layer was reduced compared to the fellow eye. Macular OCT angiography may reflect the macular structural changes caused by reduced vision.