Association Between Macular OCT/OCTA Parameters and Visual Acuity in Glaucoma

Abstract

Purpose : To investigate if macular optical coherence tomography (OCT)/OCT angiography (OCTA) parameters demonstrate correlation with visual acuity (VA) in glaucoma eyes.

Methods : Pseudophakic primary open angle glaucoma eyes were included in this cross-sectional study. Foveal VD (fVD), parafoveal VD (pfVD), perifoveal VD (perifVD), and whole-image VD (wiVD) of both superficial and deep layers, and their corresponding GCC thicknesses were calculated from OCTA 6x6 mm² macular scans. The area and circumferences of foveal avascular zone (FAZ) and foveal density 300 (FD300) were also measured. Univariable and multivariable linear mixed model were performed to characterize the correlation between OCT/OCTA parameters and logMAR VA in different glaucoma severities.

Results : 144 eyes (mean age=80.0 years) were included. VA differed significantly between early (80 eyes, mean logMAR VA=0.05) and moderate-severe (64 eyes, mean logMAR VA=0.11) glaucoma groups (P=0.003). In the multivariable analysis of early glaucoma eyes, none of the OCT/OCTA parameters correlated with VA (P>0.05 for all). In the multivariable analysis of moderate-advanced glaucoma, greater FAZ area (β=0.228, P=0.035) and circumference (β=0.063, P=0.032) were associated with worse logMAR VA (R²=0.11), but FD300 was not. Lower measurements of almost all GCC thicknesses, including superior hemifield thicknesses, were significantly associated with worse VA (β=0.002-0.003, P<0.05, R²=0.11-0.33), except for the inferior hemifields of perifGCC and wiGCC. For superficial VD, lower superior hemifield perifVD (β=0.007, P=0.045) and lower superior hemifield wiVD (β=0.008, P=0.042) correlated with worse logMAR VA (R²=0.11-0.12). For deep VD, only fVD was associated with worse logMAR VA (β=0.004, P=0.049, R²=0.11).

Conclusions : Some macular OCT/OCTA parameters, particularly GCC thickness, FAZ area and circumference were associated with VA in moderate-advanced glaucoma, but not early-stage glaucoma. Superficial and deep VD showed region-dependent association with VA, indicating the potentially differential involvement of local vasculatures in VA performance.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

 

Multivariable analysis of OCT/OCTA parameters associated with logMAR VA in early glaucoma

 

Multivariable analysis of OCT/OCTA parameters associated with logMAR VA in moderate-advanced glaucoma