Peripapillary Versus Macular Thinning to Detect Progression According to Initial Visual Field Loss Location in Normal-Tension Glaucoma.

PURPOSE: To investigate the predictive capabilities of peripapillary retinal nerve fiber layer (pRNFL) and macular ganglion cell-inner plexiform layer (mGCIPL) thinning to detect visual field (VF) progression in normal-tension glaucoma patients with an initial parafoveal scotoma (IPFS) or nasal step (INS). DESIGN: Retrospective cohort study. METHODS: A total of 185 early-stage glaucoma eyes, followed for 10 years, were retrospectively stratified into IPFS and INS groups. Progressive pRNFL and mGCIPL thinning were assessed using spectral-domain optical coherence tomography and VF progression using both event- or trend-based analysis. Kaplan-Meier survival analysis compared VF survival in each VF phenotype with or without progressive pRNFL and mGCIPL thinning. Cox proportional regression analysis identified VF progression factors. RESULTS: VF progression was detected in 42 IPFS (n = 86) and 47 INS (n = 99) eyes. Among VF progressors, pRNFL thinning was significantly faster in INS group compared to IPFS group (P < .01), while mGCIPL thinning was similar (P = .16). At 5 years, eyes with progressive mGCIPL thinning showed significantly lower VF survival in both VF phenotypes (all P < .05). Progressive pRNFL thinning showed significantly lower VF survival only in INS eyes (P = .015). Cox multivariate regression revealed that mGCIPL thinning predicted subsequent VF progression in IPFS eyes, while mGCIPL and pRNFL thinning had significant associations with VF progression in INS eyes. CONCLUSIONS: mGCIPL outperforms pRNFL at early follow-up in detecting VF progression in IPFS eyes but not INS eyes. Appropriate selection of structural parameters (mGCIPL vs. pRNFL) maximizes early VF progression detection according to initial VF defect location.

Comparison of the Circumpapillary Structure-Function and Vasculature-Function Relationships at Different Glaucoma Stages Using Longitudinal Data.

Purpose: This study investigated the global and regional correlations between longitudinal structure-function (S-F) and vasculature-function (V-F) data using circumpapillary retinal nerve fiber layer thickness (cpRNFLT) measurements from optical coherence tomography (OCT), circumpapillary vessel density (cpVD) from OCT angiography (OCTA), and the corresponding visual field mean sensitivities at different glaucoma stages. Methods: A total of 107 eyes from 107 glaucoma patients with progressive visual field (VF) changes followed up for an average of 3.33 ± 1.39 years were enrolled, including early-to-moderate (51 eyes) and advanced (56 eyes) stages. The rates of longitudinal change in the VF mean deviation (MD), cpRNFLT, and cpVD were evaluated using linear mixed-effects models and compared between different glaucoma stages. Longitudinal global and regional S-F and V-F relationships were assessed by repeated measures correlation analysis by glaucoma stage. Results: No significant differences were found in the rates of VF MD and cpVD changes (P > 0.05) between the two glaucoma stage groups. CpRNFLT decreased more rapidly in the early-to-moderate stage group (P < 0.001) in which significant longitudinal global and regional correlations were found in both S-F and V-F relationships (all P < 0.05), except for the nasal sector. Significant global and regional correlations were only found in V-F relationship in advanced stage cases (all P < 0.05). Conclusions: Significant longitudinal V-F relationships exist globally and regionally regardless of glaucoma stage but no longitudinal S-F relationship is present in advanced glaucoma. Longitudinal follow-up of cpVD parameters may be useful for monitoring glaucomatous VF progression at all disease stages.

Progressive Macular Vessel Density Loss and Visual Field Progression in Open-angle Glaucoma Eyes with Central Visual Field Damage.

PURPOSE: To investigate the association between the longitudinal changes in both macular vessel density (mVD) and macular ganglion cell-inner plexiform layer thickness (mGCIPLT) and visual field (VF) progression (including central VF progression) in open-angle glaucoma (OAG) patients with central visual field (CVF) damage at different glaucoma stages. DESIGN: Retrospective longitudinal study. PARTICIPANTS: This study enrolled 223 OAG eyes with CVF loss at baseline classified as early-to-moderate (133 eyes) or advanced (90 eyes) stage based on the VF mean deviation (MD) (-10 dB). METHODS: Serial mVDs at parafoveal and perifoveal sectors and mGCIPLT measurements were obtained using OCT angiography and OCT during a mean follow-up of 3.5 years. Visual field progression was determined using both the event- and trend-based analyses during follow-up. MAIN OUTCOME MEASURES: Linear mixed-effects models were used to compare the rates of change in each parameter between VF progressors and nonprogressors. Logistic regression analyses were performed to determine the risk factors for VF progression. RESULTS: In early-to-moderate stage, progressors showed significantly faster rates of change in the mGCIPLT (-1.02 vs. -0.47 µm/year), parafoveal (-1.12 vs. -0.40%/year), and perifoveal mVDs (-0.83 vs. -0.44%/year) than nonprogressors (all P < 0.05). In advanced stage cases, only the rates of change in mVDs (parafoveal: -1.47 vs. -0.44%/year; perifoveal: -1.04 vs. -0.27%/year; all P < 0.05) showed significant differences between the groups. By multivariable logistic regression analyses, the faster rate of mVD loss was a predictor of VF progression regardless of glaucoma stage, while the rate of mGCIPLT loss was significantly associated with VF progression only in early-to-moderate stage cases. CONCLUSIONS: Progressive mVD loss is significantly associated with VF progression (including central VF progression) in the OAG eyes with CVF loss regardless of the glaucoma stage. FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Utility of targeted mean total deviation trend analysis for detecting progressive visual field changes in early-to-moderate stage glaucoma.

OBJECTIVES: To evaluate the clinical utility of trend-based analysis of the targeted mean total deviation (TMTD) by comparing its rates of visual field (VF) change and sensitivities of detecting VF progression with those of the mean total deviation (mTD) in the global and hemifield VF area in early to-moderate glaucoma patients. METHODS: A single eye from 139 open-angle glaucoma patients with hemifield VF defects and a minimum two year follow-up were retrospectively evaluated. The TMTD was estimated by averaging the total deviation (TD) values after excluding VF points that had a threshold sensitivity of <0 dB in three baseline tests, and the mTD by averaging the entire VF TD values. The study patients were classified as VF progressors vs. non-progressors using both event- and trend-based analysis. The rates of change and ratios of progression detection were compared between TMTD and mTD. RESULTS: This study included 49 VF progressors and 90 non-progressors. Slopes for the global and VF-affected hemifield TMTD were significantly faster than those for the mTD in each subgroup and in the entire cohort (P < 0.001). Trend-based TMTD analysis detected VF progression in greater proportion than either trend-based mTD or event-based analysis (38.1% vs. 30.2% vs. 27.3%, respectively: VF affected hemifields). CONCLUSIONS: The rates of change in the TMTD are significantly faster than those for the mTD globally and in the VF-affected hemifields. Trend-based TMTD analysis shows greater sensitivity for detecting VF progression than trend-based mTD or event-based analysis in early-to-moderate glaucoma patients with hemifield VF loss.

Topographic comparison of the retinal microvascular changes between patients with compressive and glaucomatous optic neuropathies.

We investigated the difference in optical coherence tomography angiography characteristics between the patients with compressive optic neuropathy (CON, n = 26) and glaucomatous optic neuropathy (GON, n = 26), who were matched for the severity of visual field defect. The peripapillary retinal nerve fiber layer (pRNFL) thickness in the nasal and temporal sectors was thinner in the CON group, whereas the inferior pRNFL thickness was thinner in the GON group. Accordingly, the CON group had lower peripapillary vessel density (pVD) in the nasal and temporal sectors, and the GON group in the inferior sector. In the macular area, the CON group had a thinner macular ganglion cell-inner plexiform layer in the superior and nasal sectors, whereas the GON group in the inferior sector. However, the CON group did not have a lower macular VD than the GON group in any sector, whereas the GON group exhibited lower superficial capillary plexus VD in the superior, inferior, and temporal sectors. Comparison of the structure-vasculature correlation revealed a significant difference in the nasal and temporal peripapillary areas and superior and nasal macular sectors; a decrease in VD was greater in the GON group than in the CON group when the comparable structural change occurred.

Association of baseline optical coherence tomography angiography with the development of glaucomatous visual field defects in preperimetric glaucoma eyes.

AIMS: To evaluate whether baseline vessel density (VD) parameters derived from optical coherence tomography angiography (OCT-A) is associated with the development of glaucomatous visual field (VF) defects in preperimetric glaucoma (PPG) patients. METHODS: One eye from each of 200 consecutive PPG patients with a normal standard automated perimetry and OCT-A at baseline was retrospectively analysed. OCT-A was used to measure the circumpapillary VD (cpVD) and the parafoveal and perifoveal VD. The retinal nerve fibre layer (RNFL) and macular ganglion cell-inner plexiform layer thicknesses were measured as reference standards. Two patient groups were stratified based on the development of repeatable glaucomatous VF loss. A Cox proportional hazards model was constructed to determine the predictive ability of OCT-A parameters for VF defects. The correlation between these baseline OCT-A parameters and the rate of global VF sensitivity loss (dB/year) was calculated using linear regression analysis. RESULTS: During a 3.1-year average follow-up period, 18 eyes (9.0%) developed glaucomatous VF defects. At baseline, the lower inferior temporal cpVD (HR (95% CI)=0.934 (0.883 to 0.988); p=0.017) and thinner inferior RNFL (HR (95% CI)=0.895 (0.839 to 0.956); p=0.001) were predictive of glaucomatous VF loss. A lower inferior temporal cpVD and thinner RNFL at baseline were associated with faster rate of global VF sensitivity loss (ß=0.015; p=0.001). CONCLUSION: In PPG eyes, a lower baseline inferior temporal cpVD is significantly associated with glaucomatous VF defect development and a faster rate of global VF loss.

Foveal avascular zone vessel density is associated with visual field progression in early-stage glaucoma eyes with central visual field damage.

We investigated the relationship between foveal avascular zone (FAZ)-related parameters, assessed by optical coherence tomography angiography (OCT-A), and visual field (VF) progression in early-stage open-angle glaucoma (OAG) eyes with central visual field (CVF) defects. Early-stage glaucoma eyes [VF mean deviation (MD) ≥ - 6 dB] with CVF defects were included. The rates of longitudinal change in FAZ-related parameters and structural parameters were evaluated and compared between VF progressors and non-progressors, using linear mixed effects models. Cox proportional hazards model and linear regression models were used to identify factors associated with VF progression, the VF MD reduction rate and the change rate of mean total deviation in central 12 VF points (MTD10). A total of 131 eyes were included and VF progression was detected in 32 eyes (24.4%) during 3.45 years of follow-up. The rates of reduction in vessel density in the 300 µm width annular region surrounding the FAZ (FD300) and macular ganglion cell-inner plexiform layer thickness (mGCIPLT) were significantly faster in progressors than in non-progressors. The faster VF MD or MTD10 reduction rates were associated with faster rates of FD300 loss and mGCIPLT reduction. The FD300 reduction rate is significantly associated with VF progression in early-stage OAG eyes with CVF defects. FD300 may be an adjunctive biomarker of VF progression in glaucomatous eyes with CVF defects.

Morning Blood Pressure Surge and Glaucomatous Visual Field Progression in Normal-Tension Glaucoma Patients With Systemic Hypertension.

PURPOSE: To investigate the impact of a morning blood pressure surge (MBPS) at baseline on subsequent visual field (VF) progression in hypertensive, normal-tension glaucoma (NTG) patients receiving oral anti-hypertensive treatment. DESIGN: Retrospective cohort study. METHODS: A total of 127 eyes from 127 newly diagnosed NTG patients treated for systemic hypertension and followed up for at least 2 years were analyzed. All patients underwent baseline 24-hour ambulatory blood pressure monitoring (ABPM) and at least 5 serial VF examinations during the follow-up period. VF progression was defined according to the Early Manifest Glaucoma Trial criteria. The associations of VF progression with 24-hour ABPM-based blood pressure (BP) parameters (including MBPS) and other clinical variables were analyzed using Cox regression analyses. Kaplan-Meier survival analysis was used to compare VF survival estimates in patients with and without MBPS. RESULTS: VF progression was detected in 38 eyes (29.9%) over a 5.2-year mean follow-up. In the multivariate Cox regression model, a greater MBPS (hazard ratio [HR] = 1.033; P = .024) and lower nighttime mean arterial pressure (MAP) trough (HR = 0.965; P = .031) at baseline were significant independent predictors of subsequent VF progression. The likelihood of VF progression was significantly greater in patients with higher MBPS (P = .021) at baseline according to Kaplan-Meier survival analysis. CONCLUSIONS: An increased MBPS at baseline is a significant independent predictor of subsequent VF progression in NTG patients with systemic hypertension. This may be another relevant BP parameter associated with VF progression in hypertensive NTG patients receiving oral anti-hypertensive treatment.

Association of superficial macular vessel density with visual field progression in open-angle glaucoma with central visual field damage.

Identifying the clinical relevance of superficial versus deep layer macular vessel density (mVD) in glaucoma is important for monitoring glaucoma patients. Our current retrospective longitudinal study investigated the association of superficial and deep layer mVD parameters with glaucomatous visual field (VF) progression in mild to moderate open-angle glaucoma (OAG) eyes with central visual field (CVF) damage. Serial optical coherence tomography (OCT) angiography-derived mVD measurements were obtained in 182 mild to moderate OAG eyes (mean deviation ≥ -10 decibels). Forty-eight eyes (26.4%) showed VF progression during a mean follow-up of 3.5 years. The parafoveal and perifoveal mVDs of both superficial and deep layers showed significantly faster reduction rates in the VF progressors than in the non-progressors according to linear mixed effects models (P < 0.05). Cox and linear regression analyses showed that greater reduction rates of both the superficial layer parafoveal and perifoveal mVDs, but not their deep layer counterparts, were significant predictors of VF progression and faster VF loss (P < 0.05). In conclusion, faster rates of change in superficial but not deep layer mVD parameters are significantly associated with subsequent VF progression and faster VF deterioration in mild to moderate OAG eyes with CVF damage.

Association of macular structure, function, and vessel density with foveal threshold in advanced glaucoma.

Identifying new biomarkers associated with central visual function impairment is important in advanced glaucoma patients. This retrospective cross-sectional study enrolled 154 eyes from 154 subjects, consisting of 86 patients with advanced open-angle glaucoma (mean deviation of 24-2 visual field [VF] tests < - 15 dB) and 68 healthy controls. Structure, function, and vessel density (VD) parameters were obtained using optical coherence tomography (OCT), 24-2 standard automated perimetry, and OCT angiography, respectively. The relationships of macular thickness, central 5° and 10° VF mean sensitivity (MS), and macular VD parameters with foveal threshold (FT), representing central visual function, were investigated using partial correlation analyses and linear regression analyses, with age adjustment. Superficial and deep layer macular VD, central 5° and 10° VF MS, and best corrected visual acuity (BCVA) correlated significantly with FT after age adjustment (P < 0.05). In multivariate linear regression analyses, FT associated significantly with BCVA (ß = - 8.80, P < 0.001), central 5° MS (ß = 0.30, P = 0.037), and deep-layer global parafoveal VD (ß = 0.37, P = 0.037). Thus, deep-layer parafoveal VD is an independent predictor of FT and may be a potential biomarker for central visual function in advanced glaucoma.

Vasculature-function relationship in open-angle glaucomatous eyes with a choroidal microvasculature dropout.

Identifying biomarkers associated with functional impairment is important in monitoring glaucoma patients. This retrospective cross-sectional study investigated the vasculature-function relationship in open-angle glaucoma (OAG) eyes with choroidal microvasculature dropout (CMvD) versus in OAG eyes without. Optical coherence tomography (OCT) angiography-derived circumpapillary (cpVD) and macular vessel densities (mVD) were measured in 159 early-stage OAG eyes (mean deviation > -6 dB) in accordance with the presence or not of a CMvD. OCT-derived circumpapillary retinal nerve fibre layer thickness (cpRNFLT) and macular ganglion cell-inner plexiform layer thicknesses (mGCIPLT) were also measured as reference standards. The vasculature (cpVD and mVD)-function [24-2 visual field mean sensitivity (VFMS) and central 10° VFMS (cVFMS)] and structure (cpRNFLT and mGCIPLT)-function (24-2 VFMS and cVFMS) relationships were compared using global and sectoral maps between OAG eyes with (CMvD+) and without CMvD (CMvD-). The CMvD+ eyes showed significantly steeper cpVD-24-2 VFMS and mVD-cVFMS correlations (P < 0.05). In contrast, there were no significant differences in the cpRNFLT-24-2 VFMS and mGCIPLT-cVFMS relationships between the two groups (P > 0.05). In conclusion, OAG eyes with a CMvD have significantly stronger vasculature-function relationships than eyes without. Vessel density parameters may be useful biomarkers of disease progression in early-stage OAG patients with a CMvD.

Association of Superficial and Deep Macular Microvasculature with Central Visual Field Sensitivity in Glaucomatous Eyes with High Myopia.

PURPOSE: To investigate the relationship between two distinct layers of macular vessel density (superficial vascular plexus (SVP) and deep vascular plexus (DVP)) and central visual field sensitivity (cVFS) in open-angle glaucoma (OAG) eyes with high myopia. METHOD: This retrospective cross-sectional study included 148 OAG eyes (64 highly myopic (HMG) and 84 non-highly myopic glaucomas (NMG)) as well as 54 healthy eyes. High myopia was defined as a spherical equivalent of less than -6.0 diopters or an axial length of ≥26.0 mm. The global and sectoral SVP-cVFS and DVP-cVFS relationships were compared in each group. Macular ganglion cell-inner plexiform layer thickness (mGCIPLT)-cVFS relationships were also investigated as reference standards. Linear regression analysis was performed to identify the clinical factors associated with cVFS. RESULTS: DVP-cVFS correlations were as strong as those for SVP-cVFS and mGCIPLT-cVFS in HMG eyes. In contrast, DVP-cVFS correlations were significantly lower than SVP-cVFS and mGCILT-cVFS correlations in NMG eyes. In linear regression analysis, both SVP and DVP were significantly associated with cVFS in HMG eyes, but only SVP showed a significant correlation with cVFS in NMG eyes. CONCLUSION: DVP assessment using OCT-A may be a useful tool for detecting and monitoring OAG eyes with high myopia.

Efficacy, Safety and Patient-Reported Outcomes with Preservative-Free (PF) Tafluprost or PF-Dorzolamide/Timolol Compared with Preserved Latanoprost: A Prospective Multicenter Study in Korean Glaucoma Patients with Ocular Surface Disease.

To compare the efficacy, patient-reported satisfaction, and safety of preservative-free (PF)-tafluprost, PF-dorzolamide/timolol and preservative-containing (P)-latanoprost in Korean glaucoma patients with ocular surface disease (OSD). In a multicenter, prospective, interventional, non-randomized, controlled 12-week trial, 107 eligible patients received PF-tafluprost (n = 37), PF-dorzolamide/timolol (n = 34), or P-latanoprost eye drops (n = 36). Outcomes included changes from baseline in OSD Index (OSDI) scores (primary endpoint), intraocular pressure (IOP), and patient-reported treatment satisfaction, and safety at 12 weeks. At 12 weeks, the mean total OSDI and subdomain (dry eye symptoms, visual-related function, environmental triggers) scores significantly improved from baseline with PF-tafluprost and PF-dorzolamide/timolol, but not with P-latanoprost. Significantly more PF-tafluprost than P-latanoprost recipients reported 'highly improved/improved' satisfaction (no significant difference between PF-dorzolamide/timolol and P-latanoprost). IOP changes were comparable among all three treatment groups. No new safety concerns were observed. PF-tafluprost and PF-dorzolamide/timolol showed statistically and clinically significant reductions in OSDI compared with P-latanoprost in Korean glaucoma patients with OSD.

Optic Disc Hemorrhage Is Not Associated with Global Choroidal Vessel Loss, but Is Associated with Localized Choroidal Vessel Loss in Glaucoma.

PURPOSE: To investigate the relationship between optic disc hemorrhage (ODH) and the geographic pattern (regional vs. global) of parapapillary choroidal vessel density (pCVD) loss within the ß-parapapillary atrophy (ß-PPA) in open-angle glaucoma (OAG) Methods: This retrospective cross-sectional study included 100 OAG eyes with visual field (VF) defects confined to a single hemifield (50 with and 50 without ODH, matched for age (≤10 years) and VF severity (≤1 decibel) at the same hemifield), as well as 50 healthy eyes. The pCVD was measured using optical coherence tomography angiography (OCTA). The relationships between pCVD and clinical factors were assessed globally and regionally. Logistic regression analyses were performed to determine the clinical factors associated with the presence of ODH. RESULTS: The pCVD values within ODH-affected hemiretinae of ODH+ eyes were significantly lower than those in the matched hemiretinae of ODH- eyes (p = 0.001). The presence of ODH was significantly correlated with a lower pCVD within ODH-dominant inferior hemiretinae (p < 0.05). Lower pCVD values at ODH-affected hemiretinae was significantly associated with the presence of ODH (p < 0.05). CONCLUSIONS: OAG eyes with ODH demonstrate a greater severity of regional pCVD loss at the hemiretinae spatially corresponding to the ODH location compared to OAG eyes without ODH.

Comparison of the structure-function relationship between compass microperimetry and Humphrey field analyser in myopic open-angle glaucoma eyes.

BACKGROUND/AIMS: To compare the structure-function relationship between compass microperimetry (CMP; CenterVue, Padova, Italy) and Humphrey field analyser (HFA; Carl Zeiss Meditec, Dublin, California, USA) in open-angle glaucoma (OAG) eyes with myopia. METHODS: Circumpapillary retinal nerve fibre layer thickness (cpRNFLT) and visual field (VF) mean sensitivity (MS) were obtained in 90 OAG subjects using the optical coherence tomography, CMP and HFA in a random order. The global and sectoral structure-function relationships between the cpRNFLT and VFMS were assessed with different VF devices (CMP vs HHA) in OAG eyes with and without myopia. RESULTS: Overall, the global and regional structure-function relationships between the two devices did not show significant differences except for the superotemporal sector. In the myopic subgroup, the global association between the average cpRNFLT and VFMSCMP was significantly stronger than that between the average cpRNFLT and VFMSHFA (r=0.806 vs. 0.720, p=0.035). The presence of myopia and higher global cpRNFLT were significantly associated with the greater global VFMS differences between the two devices (p<0.05). CONCLUSION: In general, structure-function relationship is similar between CMP and HFA in OAG eyes. However, the global structure-function relationship is significantly stronger with CMP than with HFA in OAG eyes with myopia.

Glaucoma diagnostic capabilities of macular vessel density on optical coherence tomography angiography: superficial versus deep layers.

BACKGROUND/AIMS: To compare glaucoma diagnostic capabilities of superficial and deep macular vessel density (mVD) parameters in a series of healthy and open-angle glaucoma (OAG) eyes with central visual field (CVF) loss. METHODS: We consecutively enrolled 113 eyes of 113 patients with OAG and 47 eyes of 47 healthy participants in a retrospective manner. Superficial and deep mVDs were measured at foveal, parafoveal and perifoveal locations on optical coherence tomography (OCT) angiography. The macular ganglion cell-inner plexiform layer thickness (mGCIPLT) was measured on OCT as a reference standard. Glaucoma diagnostic capabilities of superficial and deep mVD parameters were assessed according to the glaucoma stage. Factors associated with the CVF mean sensitivity (MS) were evaluated using linear regression analyses in the OAG eyes. RESULTS: Glaucoma diagnostic capabilities of superficial perifoveal and parafoveal mVDs were significantly better than those of deep perifoveal and parafoveal mVDs, regardless of the glaucoma stage (both p<0.05). Both mGCIPLT and superficial parafoveal mVD were significantly associated with CVF MS (ß-coefficients=10.567 and 21.147, respectively, both p<0.05), independent of age and glaucoma severity. CONCLUSION: Superficial mVD parameters showed significantly greater glaucoma diagnostic capabilities and better correlation with CVF MS compared with deep mVD parameters.

Baseline Vessel Density Parameters for Predicting Visual Field Progression in Open-Angle Glaucoma Eyes With Central Visual Field Damage.

PURPOSE: To identify the baseline vessel density (VD) parameters that predict visual field (VF) progression in patients with open-angle glaucoma (OAG) with central visual field (CVF) damage. DESIGN: Retrospective cohort study. METHODS: This study enrolled 208 eyes from 208 consecutive patients with OAG with CVF damage at baseline and with a minimum 2 years of follow-up. Optical coherence tomography (OCT) angiography was used to measure circumpapillary and macular VDs in the retina and parapapillary VD in the choroid (pCVD) at the baseline. The circumpapillary retinal nerve fiber layer (cpRNFL) and macular ganglion cell-inner plexiform layer (mGCIPL) thicknesses were also measured as reference standards. Cox proportional hazard analysis was performed to identify the baseline clinical factors associated with VF progression according to the glaucoma stage. The relationships between the CVF mean sensitivity reduction rate during follow-up and the baseline clinical factors were evaluated. RESULTS: VF progression was detected in 54 eyes (26.0%) during 2.78 years of mean follow-up. A lower pCVD (hazard ratio = 0.916, P = .014) at baseline in early-stage OAG eyes and a reduced baseline average mGCIPL thickness (hazard ratio = 0.896, P = .001) in eyes with moderate to advanced glaucoma were independent predictors of VF progression. The baseline pCVD (ß = 0.018, P = .028) in eyes with early-stage glaucoma and the baseline average mGCIPL thickness (ß = 0.035, P = .013) in eyes with moderate to advanced glaucoma were significantly correlated with the rate (dB/y) of CVF mean sensitivity reduction. CONCLUSION: In eyes with OAG with CVF damage, a lower baseline pCVD in early-stage glaucoma and a reduced mGCIPL thickness at baseline in moderate to advanced glaucoma are significantly associated with subsequent VF progression.

Clinical characteristics of choroidal microvasculature dropout in normal-tension glaucoma versus nonarteritic anterior ischemic optic neuropathy: an optical coherence tomography angiography study.

The present study investigated the characteristics of choroidal microvasculature dropout (CMvD) in eyes with nonarteritic anterior ischemic optic neuropathy (NAION) versus those in eyes with normal-tension glaucoma (NTG). This study included 27 NAION, 27 NTG, and 27 healthy control subjects. CMvD was observed in 15 eyes (55.6%) of the NAION group and 20 (74.1%) of the NTG group. The area and angular width of CMvD were significantly greater in eyes with NAION (0.278 ± 0.172 mm2 and 86.5 ± 42.3°) than in those with NTG (0.138 ± 0.068 mm2 and 35.1 ± 16.2°, p = 0.002 and p < 0.001, respectively). CMvD in eyes with NAION were distributed in 120-250° and most frequently located at the temporal region, while CMvD in eyes with NTG showed double peaks at 220-280° and 110-140° and most frequently located at the inferotemporal region. The factors associated with the discrimination of NAION from NTG were greater area of CMvD (OR, 1.181; 95% CI, 1.021-1.366; p = 0.025) and location closer to the temporal region of the CMvD (OR, 0.904; 95% CI, 0.838-0.975; p = 0.009). The clinical characteristics of CMvD differed between eyes with NAION and those with NTG. Optical coherence tomography angiography may provide an additional approach to differentiating glaucoma from NAION.

Comparison of the 24-2 and 24-2C Visual Field Grids in Determining the Macular Structure-Function Relationship in Glaucoma.

PRECIS: The 24-2C grid showed significantly greater structure-function (S-F) associations in the global and regional sectors than the 24-2 visual field (VF) grid in open-angle glaucoma eyes. PURPOSE: The aim was to compare a Humphrey Field Analyzer (HFA) Swedish Interactive Threshold Algorithm-Faster (SITA-faster) 24-2C grid to a conventional HFA 24-2 grid regarding macular S-F relationships. METHODS: The macular ganglion cell-inner plexiform layer thickness (mGCIPLT) was measured at different parafoveal sectors using spectral-domain optical coherence tomography in 150 eyes from 150 healthy, preperimetric, and perimetric glaucoma subjects. The central visual field mean sensitivity (VFMS) on the decibel and 1/L scales and the parafoveal mGCIPLT were matched topographically in 4 sectors and the strengths of the S-F relationships were assessed using "weighted" correlation coefficients and compared between 24-2C and 24-2 VF test grids. RESULTS: There were significant global and sectoral correlations between the mGCIPLT and VFMS using both VF grids. The S-F correlations between the average/hemimacular mGCIPLT and the corresponding VFMS using a 24-2C grid were however significantly greater in both the entire and perimetric glaucoma groups (P<0.05), except for the average mGCIPLT of the perimetric glaucoma group in the 1/L scale (P=0.065). The 24-2C grid showed significantly greater S-F associations in the superotemporal and inferotemporal parafoveal sectors than the 24-2 VF grid (both P<0.05). CONCLUSIONS: A 24-2C grid may offer an advantage over the conventional 24-2 VF grid in assessing macular S-F relationships.