Association of parapapillary microvascular dropout with visual field in glaucoma

Abstract

BACKGROUND: Glaucoma is a disease with an optic neuropathy that is associated with visual field defects, of which the exact pathomechanism is unclear. Vascular abnormalities play an important role in the pathogenesis of glaucoma, which is evidenced in cases of microvascular dropout (MvD). Visual field damage related to glaucoma has recently been associated with MvD. This study aimed to determine the association between MvD in the parapapillary layer and the visual field in glaucoma patients.METHODS: The study used a cross-sectional and non-randomized research design. In accordance with the specified sample, 29 individual eyes from 23 patients with varying degrees of early, moderate, or severe open-angle, closed-angle, or normotensive glaucoma were obtained. The retinal nerve layer thicknesses (RNFLs) of all participants were examined to establish the diagnosis of glaucoma using optical coherence tomography (OCT) and optical coherence tomography angiography (OCT-A) imaging to view peripapillary microvascular images. The samples were divided into two groups, those with microvascular dropout (MvD) and those without MvD. The visual field parameter and RNFL thickness difference analysis was evaluated using the Mann-Whitney Test, while the topographic relationship between the MvD and visual field was analyzed using the Spearman correlation. The structure-function relationship was presented and compared using scatterplots.RESULTS: The results revealed significant differences in visual field parameters and RNFL thicknesses between the MvD and without MvD groups. A topographical relationship was observed between MvD and visual field sensitivity. In addition, the structure-function relationship suggested that the severity of visual field sensitivity was more pronounced than that of RNFL thickness in the group with MvD.CONCLUSIONS: The MvD-affected eyes showed more severe visual field damage and deeper structure-function relationships than without MvD group. A topographic relationship between MvD and visual field was also found, which suggests a role for MvD in visual field defects.

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