Optical Coherence Tomography Angiography and Visual Field Progression in Primary Angle Closure Glaucoma

H.L. Rao*, T. Srinivasan, Z.S. Pradhan, S. Sreenivasaiah, D.A.S. Rao*, N.K. Puttaiah, S. Devi, S. Moghimi, K. Mansouri, C.A.B. Webers, R.N. Weinreb

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

6 Citations (Web of Science)

Abstract

Precis: Lower whole enface disc (coefficient: 0.02, P=0.03) and macular vessel densities (coefficient: 0.04, P=0.02) on optical coherence tomography angiography (OCTA) were significantly associated with faster rate of mean deviation (MD) decline. Purpose: To evaluate the association between OCTA features and prior visual field (VF) progression in primary angle closure glaucoma (PACG). Methods: In a cross-sectional study, 46 eyes of 31 PACG patients with 5 reliable VF examinations performed over >= 3 years of follow-up underwent OCTA imaging. Effect of clinical (age, sex, number of antiglaucoma medications, mean, and SD of intraocular pressure during follow-up), optical coherence tomography (average retinal nerve fiber layer and ganglion cell complex thickness) and OCTA (whole enface vessel density of disc and macular scan, deep-layer microvascular dropout) parameters on the rate of MD change was evaluated using linear mixed models. Results: Average (+/- SD) MD of the baseline VF was -7.4 +/- 7.3 dB, and rate of MD change was -0.32 +/- 0.29 dB/y. Whole enface vessel density of disc and macular scans was 39.5%+/- 8.1% and 38.7%+/- 4.4%, respectively. Microvascular dropout was noted in 33.3% of the eyes. Multivariate mixed models showed that lower whole enface disc (coefficient: 0.02, P=0.03) and macular vessel densities (coefficient: 0.04, P=0.02) were significantly associated with faster rate of MD decline. Other factors significantly associated with faster progression in multivariate models were older age (coefficient: -0.02, P<0.05) and the presence of systemic hypertension (coefficient: -0.37, P=0.01) and diabetes (coefficient: -0.28, P=0.05). Conclusions: Lower superficial vessel density measured using OCTA was significantly associated with faster VF progression in PACG. In these eyes, OCTA parameters can serve as biomarker suggestive of past VF progression.
Original languageEnglish
Pages (from-to)E61-E67
Number of pages7
JournalJournal of Glaucoma
Volume30
Issue number3
DOIs
Publication statusPublished - 1 Mar 2021

Keywords

  • primary angle closure glaucoma
  • progression
  • optical coherence tomography angiography
  • vessel density
  • microvascular dropout

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