Greater Severity of Glaucomatous Damage in Eyes With Than Without Choroidal Microvasculature Dropout in Open-Angle Glaucoma

Abstract

Purpose: To assess whether open-angle glaucoma (OAG) eyes with choroidal microvasculature dropout (CMvD) have greater severity of glaucomatous damage compared to those eyes without CMvD.

Methods: In this retrospective case-control study, 80 eyes of 80 OAG patients with visual field (VF) defects confined to a superior hemifield (40 eyes with CMvD and 40 eyes without CMvD matched for age [≤10 years], axial length [≤1 mm], and VF loss [≤1 dB (decibel)]) and 43 healthy eyes were consecutively included. The circumpapillary retinal nerve fiber layer thickness (cpRNFLT), macular ganglion cell-inner plexiform layer thickness (mGCIPLT), circumpapillary vessel density (cpVD), parafoveal VD (pfVD), and VF mean sensitivity (VFMS) were measured. The relationships between CMvD angular extent and structural/VD/functional measures were assessed at both hemiretinae in OAG eyes with CMvD. Logistic regression analyses were performed to evaluate the associations between significant cpRNFLT reduction at perimetrically intact hemiretinae and relevant clinical variables.

Results: Sectoral cpRNFLT and mGCIPLT in the perimetrically intact hemiretinae of eyes with CMvD were significantly lower than those of eyes without CMvD (P < 0.05). There were significant correlations between CMvD angular extent and sectoral measures of structural/VD/functional parameters at perimetrically intact hemiretinae as well as perimetrically affected hemiretinae in OAG eyes with CMvD. The presence and extent of CMvD had a significant influence on cpRNFLT reduction at perimetrically intact hemiretinae (P < 0.05).

Conclusions: OAG eyes with CMvD showed significantly lower cpRNFLT and mGCIPLT than those without CMvD at the hemiretinae corresponding to intact hemifields, thus requiring more vigilant attention for greater disease severity.