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Decreased macular deep capillary plexus is associated with functional progression of normal tension glaucoma patients with unilateral visual field loss
  1. Sigeng Lin1,2,
  2. Xiao Shang1,2,
  3. Xiaoyan Wang1,2,
  4. Xizhong Chu1,2,
  5. Chengju Hu1,2,
  6. Yuqing Si1,2,
  7. De-fu Chen1,2,
  8. Weihe Zhou1,2,
  9. Yu Xiang George Kong3,4,5,
  10. Yuanbo Liang1,2
  1. 1Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
  2. 2National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
  3. 3Department of Ophthalmology, The University of Melbourne, The University of Melbourne, Melbourne, Victoria, Australia
  4. 4Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
  5. 5Centre for Eye Research Australia, East Melbourne, Victoria, Australia
  1. Correspondence to Dr Yuanbo Liang, Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, 325027, China; yuanboliang{at}


Purpose To investigate whether quantitative optical coherence tomography angiography (OCTA) metrics of the superficial/deep macular retina are associated with the development of visual field (VF) loss in the fellow eyes of normal tension glaucoma (NTG) patients with unilateral VF loss.

Methods A longitudinal study was conducted in which 61 eyes with normal VF (mean VF mean deviation −0.7±1.6 dB) from 61 NTG patients were included. All subjects underwent OCTA imaging, spectral-domain-OCT imaging and VF testing. OCTA metrics of superficial capillary plexus and deep capillary plexus (DCP) in the macular region were measured. Relationships between baseline OCTA metrics, demographics and ocular characteristics and the risk of VF glaucoma progression were analysed with a Cox proportional hazards model.

Results During a mean follow-up of 38 months, 11 fellow eyes (18.0%) with normal VF at baseline were determined to have VF progression, while 21.3% of affected eyes had VF progression. After adjustment for potential confounding factors, decreased baseline DCP in the fellow eyes was significantly associated with future VF progression (HR 1.33, 95% CI 1.03 to 1.73, p=0.031).

Conclusion Decreased DCP was associated with a higher risk of developing VF damage in NTG patients with unilateral VF loss. Assessments of DCP may help improve the evaluation of the risk of functional deterioration in fellow eyes with an initially normal VF.

  • Glaucoma

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 Study design: YL, SL; Data acquisition: SL, XS, XW, XC, CH, YS and D-FC; Writing, reviewing and editing: YL, SL and YXGK; Technical and material support: WZ.

    The corresponding author attests that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted. YL isthe guarantor.

  • Funding This study was supported by National Key R&D Program of China 2020YFC2008200, Leading Talents in Science and Technology of Zhejiang Ten Thousand Talents Program 2021R52012 and Key Research and Development Program of Zhejiang 2022C03112.

  • Competing interests None declared.

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