Abstract
Purpose :
To evaluate the circumpapillary and retinal vessel density in glaucomatous patients with arcuate scotoma in superior or inferior hemifield, and undamaged other hemifield
Methods :
In a prospective study were included 21 glaucomatous patients with superior arcuate scotoma and undamaged inferior hemifield (mean age 64±5 yrs), 20 glaucomatous patients with inferior arcuate scotoma and undamaged superior hemifield (mean age 65±5 yrs), and 22 healthy controls (mean age 64±6 yrs). Glaucomatous patients had IOP ≤ 18 mmHg by topical treatment.
All received systemic blood pressure and IOP measurement (mean ocular perfusion pressure -OPP- was calculated), 24-2 visual field testing by Humprey 750i perimeter, and examination by spectral domain-OCT Avanti and Optovue angio-OCT (Optovue Inc., Fremont, CA).
The following scanning protocols were used: ONH for the circumpapillary RNFL (cpRNFL) thickness, HD angio disc 4.5 for the circumpapillary vessel density (cpVD), GCC thickness for macular ganglion cell complex (mGCC) thickness, HD angio retina 6 for superficial and deep retinal vessel density.
The values detected in inferior and superior hemifields, and in 8 sectors for circumpapillary parameters, were considered.
Results :
Among the groups, no significant difference was seen in OPP.
Glaucomatous patients had lower values of RNFL thickness, cpVD, superficial and deep retinal vessel density than healthy controls (ANOVA p<0.001).
Comparing the two groups of glaucomatous patients, those with superior arcuate scotoma had, in inferior hemifield, lower RFNL thickness and cpVD (in particular in infero-nasal, and infero-temporal sectors), mGCC thickness and superficial vessel density in parafoveal and perifoveal area (Tukey HSD p<0.01). Patients with inferior scotoma had lower values of all these parameters in superior hemifield (supero-temporal and supero-nasal sectors of circumpapillary RFNL thickness and cpVD) (Tukey HSDp<0.01). A significant correlation was found between RNFL thickness, cpVD, GCC thickness and superficial vessel density in parafoveal and perifoveal area of one hemifield, with mean sensitivity and pattern deviation of the other hemifield (p<0.05).
Conclusions :
Glaucomatous eyes with arcuate scotoma in one hemifield have RNFL and retinal ganglion cell damage in the other hemifield, that is related with a reduction in circumpapillary or retinal vessel density.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.