Abilities of circumpapillary retinal nerve fiber layer thickness and vascular density to discriminate stages in primary open-angle glaucoma.

PURPOSE: To clarify the abilities of circumpapillary retinal nerve fiber layer thickness (cpRNFLT) obtained by optical coherence tomography (OCT) and circumpapillary vessel density (cpVD) measured by OCT-angiography to distinguish different stages in primary open-angle glaucoma determined by 24-2 or 30-2 static visual field (VF) testing. METHODS: This retrospective study includes 25 healthy normal eyes of 25 subjects and 87 primary open-angle glaucoma eyes of 87 patients. Areas under the receiver operating characteristic curves (AUROC) were evaluated for determining glaucoma stages using cpRNFLT and cpVD. The absolute errors of the estimated mean total deviation (mTD) using optimal models with cpRNFLT and cpVD were also compared. RESULTS: The AUROCs for discriminating glaucomatous eyes from normal eyes was significantly higher for cpRNFLT than the respective AUROCs for cpVD (0.969 [95% CI 0.939 to 0.998] vs. 0.872 [95% CI 0.806 to 0.938], p = 0.006), whereas cpVD had significantly higher AUROC for discriminating severe glaucoma eyes from moderate glaucoma eyes than cpRNFLT (0.771 [95% CI 0.655 to 0.886] vs. 0.578 [95% CI 0.420 to 0.736], p = 0.022). The mean absolute error in estimating mTD using both cpRNFLT and cpVD was significantly less than the error using cpRNFLT alone (4.56 ± 3.76 dB vs. 5.39 ± 4.00 dB, p = 0.027). CONCLUSION: Our results suggest that cpVD is better for follow-ups after moderate stage. The combination of cpRNFLT and cpVD may improve VF estimation compared to cpRNFLT alone.

Narrowing Ratio of Retinal Veins at Arteriovenous Crossing in Patients With Branch Retinal Vein Occlusion Versus That in Healthy Individuals.

Purpose: This cross-sectional study aimed to clarify the differences in the retinal venous narrowing ratio (VNR) at retinal arteriovenous crossing by optical coherence tomography (OCT) among the eyes with branch retinal vein occlusion (BRVO), fellow eyes of patients with BRVO, and eyes of individuals without BRVO and to determine factors that influence the VNR. Methods: We studied 31 eyes of young participants, 54 eyes of an older control group, 56 fellow eyes of patients with BRVO, and 48 eyes with BRVO. Cross-sectional OCT images were used to determine the VNR at two arteriovenous crossings per eye. Results: Overall, 378 arteriovenous crossings were analyzed. The VNR of arterial overcrossings of fellow eyes (27.7% ± 11.1%) and BRVO eyes (27.3% ± 9.76%) were significantly higher than those in the young (16.0% ± 7.9%, all P < 0.001) and control (22.0% ± 8.81%, P < 0.001, P = 0.003, respectively) groups. The VNR of arterial overcrossings was significantly larger than that of venous overcrossings (24.0% ± 10.5% vs. 20.6% ± 13.0%, P = 0.021). A linear mixed-effects model showed that the VNR was significantly higher in arterial overcrossings, crossings with larger arterial internal diameters, smaller venous internal diameters, and participants with older age and a BRVO history. Conclusions: The VNR in arterial overcrossings was higher in BRVO eyes and even in the fellow eyes. Thus, a higher VNR in arterial overcrossings may contribute to BRVO development, and crossings with factors contributing to higher VNR might be associated with a risk of BRVO.

Swept Source-Optical Coherence Tomography-Guided Facedown Posturing to Minimize Treatment Burden and Maximize Outcome after Macular Hole Surgery.

We evaluated the closure of full-thickness macular holes (MHs) the day after surgery in minimizing the burden and maximizing patient outcomes. Herein, 25-gauge pars plana vitrectomy, internal limiting membrane peeling, and fluid-gas (20% sulfur hexafluoride) were performed for the treatment. Patients were instructed to remain in the facedown position until the confirmation of MH closure, and the position was discontinued in cases where the closure was confirmed. In total, 43 eyes of 43 patients, whose average age was 69.7 ± 8.6 years, were enrolled in this study. We used swept source (SS)-optical coherence tomography (OCT) for the confirmation of MH closure for gas-filled eyes and used spectral domain (SD)-OCT for the reconfirmation of MH closure after the gas volume was reduced to less than half of the vitreous cavity. MH closure was confirmed in 40 eyes (93%, the closure group) on the next day after surgery. The time from surgery to SS-OCT imaging was 24.7 h. Although facedown positioning was terminated in cases where MH closure was confirmed, there were no cases in which the MH was re-opened afterward. The basal and minimum MH size was significantly larger in the non-closure group than that in the closure group (p = 0.027, p = 0.043, respectively). Therefore, checking with SS-OCT the day after surgery and terminating facedown positioning in cases where MH closure was confirmed would be a useful method, removing a great burden for the elderly without sacrificing the MH closure rate.

Relationship between tinnitus and olfactory dysfunction: audiovisual, olfactory, and medical examinations.

Introduction: Sensory dysfunctions and cognitive impairments are related to each other. Although a relationship between tinnitus and subjective olfactory dysfunction has been reported, there have been no reports investigating the relationship between tinnitus and olfactory test results. Methods: To investigate the relationship between tinnitus and olfactory test results, we conducted sensory tests, including hearing and visual examinations. The subjects included 510 community-dwelling individuals (295 women and 215 men) who attended a health checkup in Yakumo, Japan. The age of the subjects ranged from 40 to 91 years (mean ± standard deviation, 63.8 ± 9.9 years). The participants completed a self-reported questionnaire on subjective tinnitus, olfactory function, and hearing function, as well as their lifestyle. The health checkup included smell, hearing, vision, and blood examinations. Results: After adjusting for age and sex, the presence of tinnitus was significantly associated with subjective olfactory dysfunction, poor olfactory test results, hearing deterioration, vertigo, and headache. Additionally, high serum calcium levels and a low albumin/globulin ratio were significantly associated with low physical activity and nutrition. Women scored higher than men in olfactory and hearing examinations, but there was no gender difference in vision examinations. Conclusion: Subjective smell dysfunction and poor smell test results were significantly associated with tinnitus complaints. Hearing and vision were associated even after adjusting for age and sex. These findings suggest that evaluating the mutual relationships among sensory organs is important when evaluating the influence of sensory dysfunctions on cognitive function.

Assessment of factors affecting flicker ERGs recorded with RETeval from data obtained from health checkup screening.

PURPOSE: To determine the factors significantly associated with the amplitudes and implicit times of the flicker electroretinograms (ERGs) recorded with the RETeval system by analyzing the comprehensive data obtained during a health checkup screening. METHODS: Flicker ERGs were recorded with the RETeval system from 373 individuals who had a normal fundus and optical coherence tomography images. The sex, age, anthropometric, ophthalmologic, and hematologic data were collected from all participants who were 40- to 89-years-of-age. Univariable and multivariable linear mixed effects regression analyses were performed to identify factors that were significantly associated with the implicit times and amplitudes of the RETeval flicker ERGs. RESULTS: Univariable linear mixed effects regression analysis showed significant correlations between the implicit times and the best-corrected visual acuity, the age, the axial length, the blood sugar level, and the blood urea nitrogen level. Analyses by multivariable linear mixed effects regression identified that the axial length (ß = 0.28), the age (ß = 0.24), and the blood sugar level (ß = 0.092) were three independent factors that were significantly correlated with the implicit times of the RETeval flicker ERGs. Univariable linear mixed effects regression analysis also showed significant correlations between the amplitudes of the RETeval flicker ERGs and the age, the platelet count, and the creatinine level. Multivariable linear mixed effects regression models identified the age (ß = -0.092), the platelet count (ß = 0.099), and the creatinine level (ß = -0.12) as three independent factors that were significantly correlated with the amplitudes of the RETeval flicker ERGs. However, the smoking habits, body mass index, and the blood pressure were not significantly correlated with either the implicit times or amplitudes of the RETeval flicker ERGs. CONCLUSIONS: Our results indicate that the age and some ophthalmologic and hematologic findings but not the anthropometric findings were significantly associated with the implicit times and amplitudes of the RETeval flicker ERGs. Thus, clinicians should remember these factors when analyzing the RETeval flicker ERGs.

Relationship Between Retinal Microcirculation and Renal Function in Patients with Diabetes and Chronic Kidney Disease by Laser Speckle Flowgraphy.

This study investigated the effect of renal dysfunction categorized by the stage of chronic kidney disease (CKD) on the retinal microcirculation assessed by laser speckle flowgraphy (LSFG) and retinal artery caliber measured by adaptive optics imaging in diabetic patients particularly the early stage of retinopathy and nephropathy. We divided the patients with diabetes into three groups based on the CKD stage (non-CKD (n = 54); CKD stage 1 + 2 (n = 20); CKD stage 3 (n = 41)). The mean blur rate (MBR) of the stage 3 CKD group was significantly lower than that of the no-CKD group (p < 0.015). The total retinal flow index (TRFI) in the stage 3 CKD group was significantly lower than that of the no-CKD group (p < 0.002). Multiple regression analysis demonstrated that CKD stage was independently associated with MBR (ß = -0.257, p = 0.031) and TRFI (ß = -0.316, p = 0.015). No significant differences were observed in external diameter, lumen diameter, wall thickness, and wall to lumen ratio among the groups. These results indicated that the ONH MBR and TRFI as assessed by LSFG decreases in diabetic patients with stage 3 CKD, but the arterial diameter measured by adaptive optics imaging does not change, suggesting that impaired renal function may be associated with decreased retinal blood flow in early-stage diabetic retinopathy.

A Novel Suturing Technique for Choroidal Avulsion.

Ocular trauma has been one of the leading causes of visual impairment, and choroidal avulsion is especially devastating. Surgical treatment of choroidal avulsion is challenging, and very few surgical techniques have been reported. We experienced two cases of globe rupture with 360-degree avulsion of the choroid-ciliary body from the peripheral section. After vitrectomy for a globe rupture, the choroid gradually slid down to the posterior pole over time and vision deteriorated even though the retina was attached. We treated the choroidal avulsion using two surgical methods: a mattress suturing technique using a 10-0 proline long needle and a 7-0 nylon single suture technique. In both methods, the retina-choroid, which had slipped down to the posterior pole, was suspended and fixed to the sclera assisted by a wide-angle viewing system, improving visual acuity. These two methods are considered to be useful surgical procedures for the treatment of an avulsed choroid.

Differences in Vascular Density between Detached and Nondetached Areas in Eyes with Rhegmatogenous Retinal Detachment.

We examined the vessel density (VD) of the deep capillary plexus (DCP) and choriocapillaris plexus (CCP) by optical coherence tomography (OCT) angiography in eyes with rhegmatogenous retinal detachment, which had similar amounts of detached and nondetached areas in the macula region, and then determined the morphology by OCT until 6 months after surgery. A total of 13 eyes of 13 patients whose average age was 55.8 ± 12.3 years and were successfully treated were enrolled in this study. Throughout the postoperative period, the VD of the DCP in the detached area decreased significantly compared to that in the nondetached area. Conversely, there was no significant difference in the VD of the CCP between the detached and the nondetached areas. The ratio of VD of both the DCP and CCP in the detached area to the in the nondetached area did not show significant changes during the follow-up period of 6 months. The ratio of VD of the DCP in the detached area to that in the nondetached area correlated significantly with the ratio of the external limiting membrane−ellipsoid zone (r = 0.57, p < 0.001) and ellipsoid zone−retinal pigment epithelium (r = 0.39, p < 0.001) thickness in the detached area to that in the nondetached area. A well-preserved DCP blood flow could result in the restoration of the outer retina.

Four-year follow up of macular intrachoroidal cavitation and chorioretinal atrophy: A case report.

RATIONALE: Macular intrachoroidal cavitation (ICC) is characterized by presence of a hyporeflective space beneath the unaltered retinal pigment epithelium (RPE) and is noted around the region of focal chorioretinal atrophy in eyes with pathologic myopia. The findings suggest that the patchy chorioretinal atrophy (PCA) progresses to ICC with time. However, there have been no reports describing long-term observational studies using OCT. We collected a case of PCA progression to macular ICC using OCT during a 4-year follow-up. PATIENT CONCERNS: A 65-year-old woman presented with metamorphopsia and blurred vision in her left eye. Her best-corrected visual acuity (BCVA) was 20/20 and spherical equivalent refraction was -14.0 diopters in the left eye. Fundus examination revealed a white, well-defined PCA at the superonasal to the fovea which showed hypofluorescence determined by autofluorescence in the left eye. Sclera curved posteriorly at the superonasal to the fovea and the choroid was thickened at the area and ellipsoid zone (EZ) was disrupted in the area in OCT images. Additionally, another OCT images through the PCA showed a disappearance of the RPE-Bruch's membrane complex and a connection of blood vessels running from the sclera to the choroid. DIAGNOSES: PCA with macular ICC. INTERVENTIONS: Observation. OUTCOMES: During 4-year follow up, the white patchy lesion and the hypofluorescence region gradually expanded. BCVA decreased with the expansion of the lesion and was 20/100 at the final visit. OCT through the fovea showed that the disorganized EZ expanded toward the ICC and the sensory retina of the fovea became thinner. Moreover, RPE-Bruch's membrane complex was not observed 3 years after the initial visit. During the follow-up period, the sensory retina was prominently displaced posteriorly to the ICC, though no obvious change was observed in the structure of the sclera. LESSONS: In cases of PCA with macular ICC, the outer retina and RPE may initially atrophy, showing as an expansion of PCA, because the attachment between the inner retina and sclera may be weakened. This may result in the displacement of the retinal tissue into the space of macular ICC.

Elevated retinal artery vascular resistance determined by novel visualized technique of laser speckle flowgraphy in branch retinal vein occlusion.

We aimed to investigate the increase in resistivity of the retinal artery in the branch retinal vein occlusion (BRVO)-affected area, and to visualize it. Thirty-two eyes of 32 patients with BRVO were measured by laser speckle flowgraphy (LSFG). The retinal artery and vein running to the BRVO-affected area and vertically symmetrical vessels in the unaffected area were examined. We applied the LSFG parameter beat strength over mean blur rate (BOM), calculated using a similar method to the pulsatility index used in Doppler flowmetry to evaluate resistivity of the vessels. Our results showed that the BOM map could clearly visualize the increase of resistivity in the retinal artery as a two-dimensional map. The BOM of the arteries in the affected area was significantly higher than that of the unaffected area (P = 0.001). Multiple regression analysis showed that the ratio of BOM in retinal arteries of the affected area to the unaffected was significantly associated with the extent of retinal hemorrhage (ß = 0.447, P = 0.009). In conclusion, the index of resistivity of the retinal artery in the BRVO-affected area was higher and could be visualized in a two-dimensional map. These findings and techniques would contribute to elucidate the pathophysiology of BRVO.

Two years outcomes of treating full-thickness macula hole associated with idiopathic macular telangiectasia type 2 by internal limiting membrane inverted flap technique: Case reports.

RATIONAL: Macular telangiectasia (MacTel) is an uncommon ocular disorder that can lead to legal blindness. MacTel type 2 is characterized by a bilateral loss of macular transparency, the presence of white crystals on the retina, aberrant blood vessel growth, and neurodegeneration of the macula. Full-thickness macular holes (FTMHs) are a prominent cause of vision reduction in MacTel type 2, and the standard care for an FTMH is pars plana vitrectomy (PPV) to restore the FTMH and best-corrected visual acuity (BCVA). However, surgical outcomes in previous reports were not good, with a lack of closure or a reopening of the FTMH, compared with those with an idiopathic FTMH. Thus, this study aimed to determine the surgical outcomes of PPV with the inverted ILM flap technique for the treatment of FTMHs with a 2-year postoperative follow-up in three patients with MacTel type 2. PATIENT CONCERNS: This study involved 3 patients who had been diagnosed with MacTel type 2 at a local eye clinic and who was subsequently referred to our department for a more detailed examination. DIAGNOSES: Three patients were diagnosed with MacTel type 2 using dilated ophthalmoscopy, fluorescein angiography, and optical coherence tomography (OCT) in both eyes. A FTMH was developed and visual acuity decreased during follow-up period in all of the patients. INTERVENTIONS: Each patient underwent PPV in 1 eye using the inverted ILM-flap technique, gas tamponade, and prone positioning. OUTCOMES: The FTMH was successfully closed in the 3 cases after the surgery. OCT showed that the FTMH remained closed at the last follow-up examination in 2 patients and vision improved to 20/20 and 20/25. In the other patient, the hole was closed temporarily after surgery, but was reopened at 6 months. The vision had improved to 20/60 until the hole was reopened, and it was 20/100 at the final follow-up examination. LESSONS: Although only 3 patients were examined, the inverted ILM-flap technique may be an effective and safe method to close an FTMH in patients with MacTel type 2. However, the surgery cannot prevent the reopening of the hole when the retinal atrophy progresses.

Changes in pulse waveforms in response to intraocular pressure elevation determined by laser speckle flowgraphy in healthy subjects.

BACKGROUND: The influences of intraocular pressure (IOP) elevations on the pulse waveform in the optic nerve head (ONH) were evaluated using laser speckle flowgraphy (LSFG) in normal subjects. METHODS: This prospective cross-sectional study was conducted at the Nagoya University Hospital. An ophthalmodynamometer was pressed on the sclera to increase the IOP by 20 mmHg or 30 mmHg for 1 min (experiment 1, 16 subjects) and by 30 mmHg for 10 min (experiment 2, 10 subjects). The mean blur rate (MBR) and the eight pulse waveform parameters determined using LSFG were measured before, immediately after and during an IOP elevation, and after the IOP returned to the baseline pressure. RESULTS: A significant elevation in the IOP and a significant reduction in the ocular perfusion pressure (OPP) were found after applying the ophthalmodynamometer (both, P < 0.001). The blowout score (BOS) reduced significantly (P < 0.001), and the flow acceleration index (FAI; P < 0.01) and resistivity index (RI; P < 0.001) increased significantly immediately after increasing the IOP by 20 or 30 mmHg (experiment 1). The BOS reduced significantly (P < 0.001), and the FAI (P < 0.01) and RI (P < 0.001) increased significantly after the IOP elevation by 30 mmHg in both experiment 2 and 1. However, the BOS and RI recovered significantly at time 10 compared to that in time 0 (immediately after IOP elevation) during the 10-min IOP elevation (P < 0.001 and P = 0.008, respectively). CONCLUSIONS: In conclusion, the BOS, FAI, and RI of the pulse waveforms changed significantly with an acute elevation in the IOP. The change should be related to the larger difference between the maximum and minimum MBRs during the IOP elevation.

Prevalence of and factors associated with dilated choroidal vessels beneath the retinal pigment epithelium among the Japanese.

Pachyvessels are pathologically dilated large choroidal vessels and are associated with the pathogenesis of several pachychoroid-related disorders, including central serous chorioretinopathy. We aimed to investigate the prevalence of and risk factors for pachyvessels in the Japanese population. We included 316 participants (aged ≥ 40 years) with normal right eyes. The presence of pachyvessels (vertical diameter > 300 µm, distance to the retinal pigment epithelium < 50 µm) was determined using 6 × 6 mm macular swept-source optical coherence tomography images, and associated risk factors were investigated. Subfoveal choroidal thickness was measured, and its associated risk factors investigated. The overall prevalence of pachychoroids was 9.5%. Regression analysis showed that a younger age, shorter axial length, male sex, and smoking were significantly associated with the presence of pachyvessels (p = 0.047; odds ratio [OR] 0.96 per year, p = 0.021; OR 0.61 per 1 mm, p = 0.012; OR 3.08 vs. female, and p = 0.011; OR 3.15 vs. non-smoker, respectively) and greater choroidal thickness (p < 0.001, p < 0.001, p < 0.003, and p < 0.017, respectively). The results were consistent with other research findings which showed that pachychoroid-related disorders such as central serous chorioretinopathy were associated with younger age, male sex, shorter axial length, and smoking. Smoking may be associated with choroidal circulatory disturbance in the Japanese population.

Peripapillary choroidal thickness assessed by spectral-domain optical coherence tomography in normal Japanese.

PURPOSE: To investigate peripapillary choroidal thickness (PPCT) in normal Japanese subjects by using spectral-domain optical coherence tomography (SD-OCT) with enhanced depth imaging (EDI) technique and evaluate its association with ocular and systemic factors. STUDY DESIGN: Cross-sectional study. METHODS: This study included 85 eyes of 85 normal Japanese subjects. Normal subjects were defined as those without retinal and optic nerve disorders of any kind. The PPCT was measured at the location of 3.4 mm diameter peripapillary circle centered on the optic nerve head. It was measured as the distance between the retinal pigment epithelium and scleral-choroidal interface at the following six sectors; temporal, supra-temporal, supra-nasal, nasal, infero-nasal, and infero-temporal. Global PPCT was calculated based on these sectorial data. In addition, association between the PPCT and ocular and systemic factors were evaluated. RESULTS: Among the included subjects, 39 (45.9%) were men and mean age was 51.4 ± 17.6 years. The mean global PPCT was 135.8 ± 40.6 µm. The infero-nasal and infero-temporal sectors were significantly thinner than other sectors (all, P < 0.05). In multiple regression analysis, thinner global PPCT was significantly associated with older age (P < 0.0001) and female sex (P = 0.0330) after considering effects of other confounders. CONCLUSIONS: This study provided global PPCT and its profile in normal Japanese subjects by using EDI SD-OCT. These results may be used as a reference in the assessment of normal status of the PPCT. The age and sex of the subjects should be considered in interpreting the PPCT data.

Rapid Morphological Restoration of Normal Foveal Contour After Spontaneous Epiretinal Membrane Separation from Retina in Eye with Macular Pseudohole: A Case Report.

PURPOSE: This study aims to report a case of idiopathic epiretinal membrane (ERM) spontaneously separated from the retinal surface even in eyes with a macular pseudohole, which was immediately followed by resolution of visual deterioration and morphological findings. CASE REPORT: A 66-year-old man presented with visual deterioration and metamorphopsia in the right eye. An ERM with a macular pseudohole in the right eye was shown by fundus examinations and optical coherence tomography (OCT) images. We intended to perform vitrectomy to remove the ERM, but within 2 months after the initial visit, the ERM spontaneously separated from the retina. Fundus photograph showed that the ERM and the macular pseudohole were absent and the fundus looked almost normal, and OCT image showed no ERM and an almost normal appearance of the retina without remaining undulations. After the ERM separation, his vision improved to 20/15. CONCLUSION: Cases with an ERM-associated macular pseudohole should be carefully monitored for the possibility of a spontaneous separation of the ERM from the retina.

Association of changes of retinal vessels diameter with ocular blood flow in eyes with diabetic retinopathy.

We investigated morphological changes of retinal arteries to determine their association with the blood flow and systemic variables in type 2 diabetes patients. The patients included 47 non-diabetic retinopathy eyes, 36 mild or moderate nonproliferative diabetic retinopathy (M-NPDR) eyes, 22 severe NPDR (S-NPDR) eyes, 32 PDR eyes, and 24 normal eyes as controls. The mean wall to lumen ratio (WLR) measured by adaptive optics camera was significantly higher in the PDR groups than in all of the other groups (all P < 0.001). However, the external diameter of the retinal vessels was not significantly different among the groups. The mean blur rate (MBR)-vessel determined by laser speckle flowgraphy was significantly lower in the PDR group than in the other groups (P < 0.001). The WLR was correlated with MBR-vessel (r = - 0.337, P < 0.001), duration of disease (r = 0.191, P = 0.042), stage of DM (r = 0.643, P < 0.001), systolic blood pressure (r = 0.166, P < 0.037), and presence of systemic hypertension (r = 0.443, P < 0.001). Multiple regression analysis demonstrated that MBR-vessel (ß = - 0.389, P < 0.001), presence of systemic hypertension (ß = 0.334, P = 0.001), and LDL (ß = 0.199, P = 0.045) were independent factors significantly associated with the WLR. The increased retinal vessel wall thickness led to a narrowing of lumen diameter and a decrease in the blood flow in the PDR group.

Nasal displacement of retinal vessels on the optic disc in glaucoma associated with a nasally angled passage through lamina cribrosa.

To investigate nasal displacement of central retinal vessel (CRV) on the optic nerve head (ONH) in glaucoma in association with its passage through lamina cribrosa (LC). This cross-sectional study included 113 eyes with glaucoma and 60 normal eyes. Horizontal spectral-domain optical coherence tomography (SD-OCT) scans of the ONH were acquired, and point where CRV emerged on the ONH surface was defined as the position of the CRV. Next, radial scans of the ONH were acquired, and angle of the CRV passing through the LC was measured. These parameters were compared between glaucomatous and normal eyes by t-test, and their relationship with possible confounders was assessed by multiple regression analyses. In glaucoma, CRV was significantly more nasally displaced than it was in normal eyes (66.0 ± 8.6 vs. 54.3 ± 9.5, P < 0.0001), and eyes with more vessel displacement exhibited significantly worse glaucomatous visual field defects (P = 0.0004). Greater nasal displacement of the CRV was significantly associated with a more nasally angled path through the LC (rs = 0.569, P < 0.0001). By using SD-OCT, we confirmed that nasal displacement of the CRV on the ONH was associated with glaucoma and was induced by its nasally angled path through the LC.