To evaluate the association between rates of choroidal microvasculature dropout (MvD) change, beta-zone parapapillary atrophy (β-PPA) area change, and visual field (VF) changes in primary open-angle glaucoma (POAG) eyes.
Retrospective, observational cohort study METHODS: In a tertiary glaucoma clinic, we included 76 eyes from 58 POAG patients with and without localized MvD, who had at least 2 years of follow-up with a minimum of 4 visits of OCTA and OCT scans. β-PPA area was evaluated using scanning laser ophthalmoscopy-like images and compared with the area of MvD on en-face choroidal vessel density map during the follow-up period. Joint longitudinal mixed effects models were used to estimate the rates of change in β-PPA area or MvD area and VF mean deviation (MD).
Mean rates of change in β-PPA and MvD area were 0.037 (95% CI, 0.030 to 0.043) mm per year and 0.039 (95% CI, 0.029 to 0.048) mm per year, respectively, over the mean follow-up of 4.1 years. In multivariable models, MvD area enlargement was significantly associated with faster rates of VF MD loss (0.03 (95% CI, 0.02 to 0.04) mm per 1 dB worse, P<0.001), not β-PPA area enlargement (0.04 (95% CI, 0.03 to 0.05) mm per 1 dB worse, P=0.252).
MvD area rates, but not β-PPA area rates, were associated with VF MD loss changes in POAG eyes. Assessment of MvD is useful for detection of glaucoma patients at a high risk of faster VF loss.

Copyright © 2023. Published by Elsevier Inc.