Asymmetry of Macular Vessel Density in Bilateral Early Open-angle Glaucoma With Unilateral Central 10-2 Visual Field Loss.

UNLABELLED

PRéCIS:: Glaucomatous eyes without detectable 10-2 visual field loss showed significant macular vessel density loss, especially in inferior quadrant of perifoveal area. Macular vessel density loss spatially corresponded with structural and functional damage.

PURPOSE

The purpose of this study was to investigate the characteristics, intereye and intraeye asymmetry of macular vessel density assessed by optical coherence tomography (OCT) angiography in bilateral early open-angle glaucoma with unilateral 10-2 visual field loss.

MATERIALS AND METHODS

Thirty-two eyes of 16 patients with bilateral early open-angle glaucoma and unilateral 10-2 visual field loss, and 13 eyes of 13 healthy participants were consecutively enrolled. All subjects underwent 30-2, 10-2 visual fields, OCT, and OCT angiography examinations. Intereye differences were compared between the perimetrically affected eye and the unaffected eye in the same patient. Intraeye differences were compared between the affected hemifields and the unaffected hemifields in the same eye with single-hemifield 10-2 visual field loss.

RESULTS

Macular whole image vessel density of the perimetrically unaffected eyes was lower than the healthy eyes (46.6% vs. 51.1%; P<0.001). Parafoveal vessel density parameters of the perimetrically affected eyes were comparable to the unaffected eyes (all P>0.05). Although inferior perifoveal vessel density of the perimetrically affected eyes was significantly lower than the unaffected eyes (42.2% vs. 46.2%; P=0.007), similar results were found in macular ganglion cell complex. In glaucomatous eyes with single-hemifield loss, perifoveal vessel density and macular ganglion cell complex of the affected hemifields were significantly worse than the unaffected hemifields (43.6% vs. 47.0%, 78.4 μm vs. 89.0 μm; P=0.023 and 0.005; respectively).

CONCLUSIONS

Significant macular microvascular damage was present in glaucomatous eyes without detectable 10-2 visual field damage. The damage of inferior perifoveal vessel density was more significant in early glaucoma. Macular microvascular damage spatially corresponded with functional and structural damage.