Structural and vascular changes in glaucoma with single-hemifield defect: predictors of opposite hemifield visual field progression

PurposeTo investigate longitudinal changes in optic nerve head (ONH) superficial vessel density (VD), macular VD, circumpapillary retinal nerve fiber layer (RNFL) thickness, and macular ganglion cell-inner plexiform layer (GCIPL) thickness, and their associations with future VF defects in unaffected hemifields of primary open angle glaucoma (POAG) eyes with baseline VF defect confined to a single hemifield.MethodsThis retrospective observational study included 61 POAG eyes with VF defect confined to a single hemifield monitored over a mean follow-up time of 2.7 years. Development of VF defect in opposite hemifield was defined based the Early Manifest Glaucoma Trail criteria. Each eye was classified into either conversion or no conversion groups according to development of VF defect in the unaffected hemifield. The rates of longitudinal changes in VD and structure parameters in each hemiretina were compared between the two groups. A Cox proportional hazard model was used to identify potential risk factors for VF conversion in the unaffected hemifield.ResultsAmong 61 eyes, 17 eyes (27.9%) were classified as conversion and 44 eyes (72.1%) were classified as non-conversion groups. The conversion group exhibited significantly greater rates of both VD and structural changes in both hemiretinas. In Cox proportional hazard model, greater rate of change in GCIPL thickness, ONH superficial VD, and macular VD of both hemiretinas and greater rate of change in RNFL thickness of the unaffected hemiretina were identified as risk factors for VF conversion in the unaffected hemifield.ConclusionsMonitoring progressive changes in VD and structural parameters effectively predict future VF defect in the opposite hemifields of POAG eyes with single-hemifield defects.

Automated summary

The purpose of this study was to investigate the longitudinal changes in VD and structural parameters and their associations with future VF defects in the unaffected hemifields of POAG eyes with single-hemifield defects. The study found that monitoring progressive changes in VD and structural parameters effectively predicted future VF defects in the unaffected hemifields of POAG eyes.