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Central macular OCTA parameters in glaucoma
  1. Takashi Nishida1,
  2. Won Hyuk Oh1,2,
  3. Sasan Moghimi1,
  4. Adeleh Yarmohammadi1,
  5. Huiyuan Hou1,
  6. Ryan Caezar C David1,
  7. Alireza Kamalipour1,
  8. Takuhei Shoji3,
  9. Nevin El-Nimri1,
  10. Jasmin Rezapour1,
  11. Linda M Zangwill1,
  12. Robert N Weinreb1
  1. 1Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California, USA
  2. 2Department of Ophthalmology, Inje University Sanggye Paik Hospital, Seoul, South Korea
  3. 3Department of Ophthalmology, Saitama Medical University, Iruma, Saitama, Japan
  1. Correspondence to Dr Robert N Weinreb, Hamilton Glaucoma Center, Shiley Eye Institute and Department of Ophthalmology, University of California San Diego Health Sciences, La Jolla, CA 92093, USA; rweinreb{at}


Background/aims To investigate the relationship between the foveal avascular zone (FAZ) parameters assessed by optical coherence tomography angiography (OCTA) and central visual field parameters in glaucoma and healthy subjects.

Methods One hundred and eighty-eight subjects (248 eyes), including 24 healthy (38 eyes), 37 glaucoma suspect (42 eyes, and 127 primary open angle glaucoma (POAG) patients (168 eyes), underwent imaging using OCTA and standard automated perimetry using the 24-2 and 10-2 Swedish Interactive Thresholding Algorithm. OCTA-based and OCT-based FAZ parameters (superficial FAZ area, FAZ circumference), foveal vessel density (FD300) and foveal thickness were measured. The correlation between FAZ parameters and visual field parameters was assessed using linear mixed model.

Results Axial length adjusted-FAZ area was not different among the three groups (mean (95% CI)): in healthy 0.31 (0.27 to 0.36) mm2, glaucoma suspect 0.29 (0.26 to 0.31) mm2 and POAG eyes 0.28 (0.27 to 0.30) mm2 (p=0.578). FD300 was lower in glaucoma suspect 49.1% (47.9% to 50.4%) and POAG eyes 48.7% (48.1% to 49.4%) than healthy eyes 50.5% (49.3% to 51.7%) though the difference was not statistically significant (p=0.071). Lower FD300 was associated with worse 24-2 and 10-2 visual field mean deviation and foveal threshold in multivariable linear mixed models (all p<0.05). In addition, a smaller FAZ area was associated with lower intraocular pressure (IOP) (p=0.026).

Conclusions The FD300, but not the FAZ area was correlated with 10° central visual field mean deviation and foveal threshold in healthy, glaucoma suspect and POAG eyes. In contrast, a smaller FAZ area was associated with lower IOP.

  • glaucoma
  • imaging
  • intraocular pressure
  • macula

Data availability statement

Data are available on reasonable request.

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Data availability statement

Data are available on reasonable request.

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  • Contributors Involved in design and conduct of the study: TN, WHO, SM and RNW. Data collection: TN, SM, HH, RCCD, AK, NE-N and JR. Analysis and interpretation of data: TN, WHO, SM and RNW. Writing: TN, AY and RNW. Critical revision: TN, SM, TS and RNW. Approval of the manuscript: TN, WHO, SM, AY, HH, RCCD, AK, TS, NE-N, JR, LMZ and RNW.

  • Funding National Institutes of Health/National Eye Institute Grants R01EY029058, R01EY011008, U10EY14267, R01EY026574, R01EY019869 and R01EY027510; Core Grant P30EY022589; an unrestricted grant from Research to Prevent Blindness (New York, NY); Inje University research grant (grant no: 20190009); UC Tobacco Related Disease Research Programme (T31IP1511); German Research Foundation (DFG, research fellowship grant RE 4155/1-1); and grants for participants’ glaucoma medications from Alcon, Allergan, Pfizer, Merck and Santen.

  • Competing interests LMZ: Financial support (research instruments)—Heidelberg Engineering, Carl Zeiss Meditec, Optovue, Topcon; Robert N. Weinreb: Financial support (research instruments)—Heidelberg Engineering, Carl Zeiss Meditec, Konan Medical, Optovue, Centervue, Bausch & Lomb; Consultant—Aerie Pharmaceuticals, Allergan, Equinox, Eyenovia; Patent—Toromedes, Carl Zeiss Meditec.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.