PURPOSE

To evaluate the association of macular superficial vessel density (SVD) and projection-resolved deep vessel density (DVD) with past visual field (VF) progression in patients with primary open-angle glaucoma.

DESIGN

Retrospective cohort.

METHODS

In this longitudinal study, 208 eyes of 147 patients with glaucoma from the Diagnostics Innovations in Glaucoma Study were included. Eligible participants were required to have at least five 24-2 VF tests over a minimum follow-up period of 3 years before macular optical coherence tomography angiography imaging. VF progression was defined based on both event-based pointwise linear regression and trend-based methods. The association of macular SVD and DVD with the probability and rate of past VF progression was evaluated using a linear mixed effects model.

RESULTS

Fifty-two (25%) eyes had VF progression based on the pointwise linear regression based criterion at the end of a mean ± standard deviation follow-up duration of 6.9 ± 1.2 years. In the event-based multivariable analysis, a lower baseline SVD was associated with a higher likelihood of past VF progression (odds ratio per 1% lower. 1.28; 95% confidence interval, 1.02–1.59). Similarly, in the trend-based multivariable analysis, lower macular SVD was associated with a faster past rate of mean deviation decline (coefficient = –0.03 dB/year; 95% confidence interval, –0.04 to –0.01). Event-based and trend-based analyses found no significant associations for macular DVD with the likelihood/rate of past VF progression (P > .05).

CONCLUSIONS

Lower macular SVD, and not DVD, was associated with a higher probability of past VF progression. Macular optical coherence tomography angiography imaging shows promise for identifying eyes at risk of VF progression in patients with glaucoma.

中文翻译：

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青光眼中的多层黄斑血管密度和视野进展

目的

评估原发性开角型青光眼患者黄斑浅表血管密度 (SVD) 和投影分辨深部血管密度 (DVD) 与过去视野 (VF) 进展的关系。

设计

回顾性队列。

方法

在这项纵向研究中，纳入了来自青光眼诊断创新研究的 147 名青光眼患者的 208 只眼睛。符合条件的参与者必须在黄斑光学相干断层扫描血管造影成像之前至少 3 年的随访期内进行至少 5 次 24-2 VF 测试。VF 进展是基于基于事件的逐点线性回归和基于趋势的方法定义的。使用线性混合效应模型评估黄斑 SVD 和 DVD 与过去 VF 进展的概率和速率的关联。

结果

在 6.9 ± 1.2 年的平均 ± 标准差随访期结束时，五十二只 (25%) 眼出现 VF 进展，基于逐点线性回归的标准。在基于事件的多变量分析中，较低的基线 SVD 与过去 VF 进展的可能性较高相关（比值比每降低 1%。1.28；95% 置信区间，1.02-1.59）。同样，在基于趋势的多变量分析中，较低的黄斑 SVD 与较快的过去平均偏差下降率相关（系数 = –0.03 dB/年；95% 置信区间，–0.04 至 –0.01）。基于事件和基于趋势的分析发现黄斑 DVD 与过去 VF 进展的可能性/比率没有显着关联 ( P > .05)。

结论

较低的黄斑 SVD，而不是 DVD，与过去 VF 进展的概率较高有关。黄斑光学相干断层扫描血管造影成像显示有希望识别青光眼患者有 VF 进展风险的眼睛。