LAUSR

PURPOSE To investigate the longitudinal changes in circumpapillary capillary density (cpCD) and retinal nerve fiber layer thickness (cpRNFLT) and their association with visual field (VF) progression in open-angle glaucoma (OAG) eyes at different stages of glaucoma. DESIGN Retrospective, observational case series METHODS: This study enrolled 158 eyes of 158 OAG patients classified into early (89 eyes) and moderate-to-advanced (69 eyes) stage based on VF mean deviation (MD; -6 dB). Serial cpCD and cpRNFLT measurements were performed using optical coherence tomography (OCT) angiography and OCT during a mean follow-up of 2.66 years. The reference standard of glaucoma progression was determined by VF progression. The rates of longitudinal change in cpCD and cpRNFLT were evaluated using linear mixed-effects models and compared between progressors and nonprogressors. The factors associated with VF progression, including the rates of longitudinal change in cpCD and cpRNFLT, were assessed using logistic regression analyses. RESULTS The rate of longitudinal change in cpCD was significantly faster in progressors (-1.25 ± 1.15 %/year for early stage and -1.61 ± 1.04 %/year for moderate-to-advanced stage) than in nonprogressors (0.04 ± 1.12 %/year for early stage and -0.34 ± 0.97 %/year for moderate-to-advanced stage) regardless of glaucoma stage (all, P<0.05). The rates of longitudinal change in cpRNFLT (-0.85 ± 1.20 μm/year vs. -0.70 ± 1.02 μm/year, P=0.396) did not differ between progressors and nonprogressors in eyes with moderate-to-advanced glaucoma. In multivariable logistic regression analyses, a faster rate of cpCD loss (odds ratio [OR], 0.244; P=0.009) had a significant association with VF progression in eyes with moderate-to-advanced glaucoma, while both faster rates of cpCD (OR, 0.340; P=0.012) and cpRNFLT (OR, 0.155; P=0.031) loss were significantly associated with VF progression in eyes with early-stage glaucoma. CONCLUSIONS In OAG eyes, the rate of longitudinal cpCD loss was significantly associated with VF progression regardless of glaucoma stage.