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.