Microvascular Density in Glaucomatous Eyes with Hemifield Visual Field Defects: An Optical Coherence Tomography Angiography Study

Abstract Purpose To investigate microcirculation of peripapillary retina and optic disc in eyes with primary open-angle glaucoma (POAG) and hemifield visual field (VF) defects. Design Prospective observational case series with normal comparison group. Methods Sixty eyes with POAG (41 with superior and 19 with inferior hemifield VF defects) and 21 normal eyes were included in this study. Optical coherence tomography (OCT) angiography was used to acquire 3 × 3 mm optic disc cubes, and circumpapillary retinal nerve fiber layer thickness was also measured using OCT. Vessel densities in the peripapillary superficial retina and whole-signal mode optic disc were individually analyzed based on the sectorial division. Results The peripapillary vessel densities were significantly reduced at the corresponding location of the VF defects in both non-highly myopic ( P < 0.001, P = 0.006) and highly myopic glaucomatous eyes ( P < 0.001, P = 0.005) compared to the normal eyes. Vessel densities of the optic discs were significantly reduced at locations corresponding to the VF defects in eyes without high myopia but with inferior hemifield VF defects ( P = 0.006), but not in the other eyes. The vessel densities in the peripapillary retina were significantly associated with visual field total deviation values at their corresponding sides. The choroidal microvascular reduction in the peripapillary area extended to the α-PPA as well as β-PPA zones. Conclusions Microvascular reduction was associated with VF defects in a region-specific manner: significantly and partially in the peripapillary retina and optic disc, respectively.