Abstract
Purpose :
While research shows that Humphrey Field Analyzer (HFA) parameters decrease with age in glaucoma suspects (GS), the effect of sex on HFA global indices continues to be explored. Our study aimed to investigate the effect of sex and circumpapillary optic nerve head vessel density (CP ONH VD) on HFA global indices in GS.
Methods :
21 GS subjects (32 eyes) were enrolled in a prospective study at Manhattan Eye, Ear and Throat hospital. Subjects, grouped by sex, underwent HFA 24-2 and Optical Coherence Tomography-Angiography (OCT-A). VD was measured on ONH OCT-A 3x3 scan using ImageJ, and major retinal vessels were subtracted from VD measurements. HFA global indices such as Mean Deviation (MD), Pattern Standard Deviation (PSD), and Visual Field Index (VFI) were recorded. Linear regression analyses were used to assess relationships between HFA global indices and CP ONH VD, after controlling for age.
Results :
After adjusting for age (Step 1) in linear regression models of the male group, CP ONH VD (Step 2) explained 47% of variance in HFA MD 24-2 (F (1,4)=9.447, B=0.176, [95% CI: 0.017, 0.334], p=0.037). Similarly, CP ONH VD explained 66.2% of variance in HFA PSD 24-2 (F (1,4)=16.912, B=-0.082, [95% CI: -0.137, -0.027], p=0.015) and explained 72.6% of variance in HFA VFI 24-2 (F (1,4)=38.402, B=0.172, [95% CI: 0.095, 0.249], p=0.003). No significant relationships were found in the female group.
Conclusions :
We report that CP ONH VD explained variance in all HFA global indices in males, but not in females. Our results align with studies reporting the effects of age and sex on HFA global indices. In today’s practice, HFA test results do not account for physiologic sex-based differences, such as the imbalance between endothelin-1 (ET1) and nitric oxide bioavailability and the ET1-lowering effects of estrogen in females. As males have increased cardiovascular risk compared to females, up to the age of 65 years old, we can infer a decrease in CP ONH VD, which may impact performance on HFA and other functional tests, such as Pattern Electroretinogram.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.