In this observational cross-sectional analysis, investigators evaluated the association between macular vascular density assessed by OCT angiography (OCT-A) and central visual field (VF) results.

Study design

The analysis included 185 eyes from 38 healthy participants, 31 glaucoma suspects, 72 mild glaucoma patients, and 44 moderate/severe glaucoma patients who were enrolled in the Diagnostic Innovations in Glaucoma Study. Each participant underwent 10-2 VF testing; macular vessel density and parafoveal vessel density were measured using OCT-A imaging.

Outcomes

Statistically significant associations were found between VF mean sensitivity and macular vessel density, as well as VF mean sensitivity of the central 4 points and parafoveal vessel density. Macular vessel density was better than ganglion cell complex thickness (measured using SD-OCT) at distinguishing glaucoma suspects from healthy eyes (P=0.010).

Limitations

OCT-A scans were performed by expert Diagnostic Innovations in Glaucoma Study personnel that have proven excellent reproducibility. Such high skill level may not be expected in daily clinical practice.

Clinical significance

The study shows a clear structure-function relationship between retinal vascular parameters and functional vision loss. The results lend credence to a vascular mechanism as fundamental to the pathology of glaucomatous optic neuropathy. Furthermore, the findings support the use of OCT-A as a diagnostic adjunct in the management of glaucoma and glaucoma suspects.