Comparison of macular vessel density changes in early primary open-angle glaucoma with central visual field defects and peripheral visual field defects / 中华实验眼科杂志

ABSTRACT

Objective:To compare the change of macular microvasculature in early primary open-angle glaucoma (POAG) patients with central visual field defects (CVFDs) and peripheral visual field defects (PVFDs).Methods:A cross-sectional study was performed.Sixty-six eyes of 66 consecutive patients with early POAG were enrolled in Beijing Tongren Hospital from June to December 2020.The patients were divided into CVFDs group (25 eyes) and PVFDs group (41 eyes) according to their visual field defect.Another 55 eyes of 55 age-, gender- and spherical equivalent-matched healthy people were set as a normal control group.All subjects underwent routine ophthalmic examination.Humphrey 24-2 visual field test was carried out.Macular vessel density (VD) and perfusion density (PD) of an area of 6 mm×6 mm were measured by optical coherence tomography angiography (OCTA), and the area was divided into 3 rings and 9 zones, including center, inner ring (superior, inferior, temporal and nasal sectors), and outer ring (superior, inferior, temporal and nasal sectors) according to ETDRS ring.The relationship among VD, PD, and visual field defect was analyzed.This study adhered to the Declaration of Helsinki.The research protocol was approved by an Ethics Committee of Beijing Tongren Hospital, Capital Medical University (No.TRECKY2020-103). Written informed consent was obtained from each subject before any examination.Results:The total macular VD of normal control group, CVFDs group and PVFDs group was 18.20 (17.50, 18.50), 17.10 (16.30, 17.85), and 17.20 (16.25, 17.90)mm/mm 2, respectively, and there was a significant difference ( H=20.84; P<0.001). The total macular PD of normal control group, CVFDs group and PVFDs group was 0.45 (0.43, 0.46), 0.42 (0.40, 0.44), and 0.43 (0.40, 0.44)mm 2/mm 2, respectively, with a significant difference ( H=16.15; P<0.001). The total macular VD and PD of CVFDs and PVFDs groups were significantly lower than those of normal control group, with statistically significant differences (all at P<0.05). Significant differences were found in VD and PD of superior, inferior, temporal, and nasal sectors of the outer ring among three groups (all at P<0.05). VD of the outer ring and PD of superior, inferior, and nasal sectors of the outer ring were reduced in CVFDs group than normal control group, showing significant differences (all at P<0.05). VD and PD of the superior, inferior, and temporal sectors of the outer ring were reduced in PVFDs group compared with normal control group, with significant differences (all at P<0.05). A significant difference was found in macular PD of the outer-nasal sector between CVFDs and PVFDs groups ( P=0.035). Conclusions:Macular VD and PD are reduced in early POAG.Compared with POAG patients with CVFDs, the macular PD of the outer-nasal sector of POAG patients with CVFDs is lower.