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Association of macular vessel density and ganglion cell complex thickness with central visual field progression in glaucoma
  1. Jo-Hsuan Wu,
  2. Sasan Moghimi,
  3. Takashi Nishida,
  4. Golnoush Mahmoudinezhad,
  5. Linda M Zangwill,
  6. Robert N Weinreb
  1. Hamilton Glaucoma Center, Shiley Eye Institute and Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA, USA
  1. Correspondence to Dr Robert N Weinreb, Hamilton Glaucoma Center, Shiley Eye Institute and Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA 92093, USA; rweinreb{at}ucsd.edu

Abstract

Background/aims To evaluate the association of macular vessel density (VD) and ganglion cell complex (GCC) thickness with 10–2 central visual field (CVF) progression in glaucoma.

Methods In this retrospective cohort study, patients with glaucoma from Diagnostic Innovation in Glaucoma Study with≥five 10–2 visual field (VF) tests and 3-year follow-up before optical coherence tomography (OCT) and OCT angiography (OCTA) imaging were included. Whole-image GCC thickness (wiGCC) and superficial VD (wiVD) were obtained from 6*6 macula scans. The association of wiVD and wiGCC with past rate of 10–2 VF mean deviation worsening, and with past CVF progression (defined using clustered linear regression criteria) was evaluated using linear mixed models after adjusting for confounders.

Results From 238 eyes (141 patients), 25 eyes (11%) of 16 patients were CVF progressors. In the multivariable analysis of the association between OCT/OCTA parameters and past rate of 10–2 CVF worsening, lower wiVD (β=−0.04 (–0.05, –0.02); p<0.001; R2=0.32) and wiGCC (β=−0.01 (–0.01, 0.00); p=0.004; R2=0.21) were significantly associated with faster CVF worsening. For the association between OCT/OCTA parameters and past CVF progression, the multivariable analysis showed that a lower wiVD was significantly associated with increased odds of past CVF progression (OR=1.23 (1.06, 1.44) per 1% lower; p=0.008), while wiGCC did not show correlation.

Conclusions Lower macular VD and GCC were associated with faster worsening of CVF, and lower macular VD was associated with increased odds of CVF progression. Assessment of macular OCT and OCTA may help detect glaucoma eyes with CVF progression.

  • Glaucoma

Data availability statement

Data are available upon reasonable request. The datasets generated and/or analysed during the current study are available from the corresponding author on reasonable request.

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Data availability statement

Data are available upon reasonable request. The datasets generated and/or analysed during the current study are available from the corresponding author on reasonable request.

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Footnotes

  • Contributors Concept and design: J-HW, SM. Acquisition and reviewing of data: J-HW, SM, TN, LMZ. Analysis or interpretation of data: all authors. Drafting of the manuscript: J-HW, SM. Critical revision of the manuscript: all authors. Obtained funding: SM, LMZ, RNW. Supervision: SM, RNW. Study guarantor: RNW.

  • Funding This work is supported by National Institutes of Health/National Eye Institute Grants (R01EY029058, R01EY11008, R01EY19869, R01EY027510, R01EY026574, R01EY018926, P30EY022589); University of California Tobacco Related Disease Research Program (T31IP1511), and an unrestricted grant from Research to Prevent Blindness (New York, NY). The sponsor or funding organization had no role in the design or conduct of this research.

  • Competing interests LZ is a consultant of Abbvie. LZ reported grants from the National Eye Institute; grants and non-financial support from Carl Zeiss Meditec, Optovue, Heidelberg Engineering, and Topcon. RNW is a consultant of Aerie Pharmaceuticals, Allergan, Equinox, Eyenovia, Iantrek, IOPtic, Implandata, Nicox, and Topcon. RNW reported non-financial support from Heidelberg Engineering, Carl Zeiss Meditec, Konan Medical, Optovue, Centervue, and Topcon; grants from the National Eye Institute, patents from Toromedes, Carl Zeiss Meditec; all outside the submitted work. No other disclosures were reported.

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