Progression detection capabilities of circumpapillary and macular vessel density in advanced glaucomatous eyes

Abstract

This study investigated the progression detection capabilities of circumpapillary and macular vessel density (cpVD and mVD) in advanced primary open angle glaucoma (POAG) eyes using the rates of change in VD (trend-based analysis) and variability limits derived from healthy eyes. (event-based analysis) This study included 75 POAG eyes [visual feld (VF) mean deviation< − 10 decibels, mean follow-up; 2.3 years] and 33 healthy eyes. Of 75 POAG eyes, 17 (22.7 %) and 58 eyes (77.3 %) were classifed into the VF progression and stable groups, respectively. The VF progression group showed signifcantly faster VD loss than the stable group. (cpVD; − 1.76 vs. − 0.84 %/year, mVD; − 1.10 vs. − 0.47 %/year, P< 0.05) However, the rates of change in circumpapillary retinal nerve fber layer and macular ganglion cell complex thickness were similar between the groups. (cpRNFLT; −0.67 vs. − 0.53µm/year, GCCT; − 0.48 vs. − 0.12µm/year, P> 0.05) Event-based analysis showed stronger agreement between VD and VF progression (cpVD; kappa value (k)= 0.630, mVD; k = 0.667, P< 0.05) than that between structure and VF progression. (cpRNFLT; k = 0.111, GCCT; k = 0.194, P> 0.05). In conclusion, VD loss showed better progression detection capabilities than structural loss in advanced POAG eyes. Detection of cpVD and mVD loss may be useful for detecting progression in the advanced stages of POAG to complement other reference standard strategies.