Choroidal Microvasculature Dropout is Associated with Generalized Choroidal Vessel Loss within the β-Parapapillary Atrophy in Glaucoma

PURPOSE: To determine whether eyes with open-angle glaucoma (OAG) and a localized choroidal microvasculature dropout (MvD) are associated with a greater degree of generalized choroidal vascular insufficiency within the beta-parapapillary atrophy (beta-PPA) than OAG eyes without MvD. DESIGN: Retrospective cross-sectional study. METHODS: This study included 100 OAG eyes with visual field (VF) loss confined to a single hemifield (50 with and 50 without MvD, matched for age [<= 10 years ols], axial length [<= 1 mm], and VF severity [<= 1 dB]), as well as 50 healthy eyes. Using optical coherence tomography angiography, parapapillary choroidal vessel density (pCVD) was measured on en-face images of choroidal maps within the entire beta-PPA after excluding the MvD area and hemi-sectors of the beta-PPA. pCVDs were compared among the 3 groups. The relationships between pCVD outcomes and various clinical variables were assessed. Logistical regression analyses were performed to determine the clinical factors associated with the presence of MvD in eyes with OAG. RESULTS: pCVDs corresponding to the VF-intact hemi-sectors and the entire beta-PPA, excluding the MvD area, were significantly lower in eyes with MvD than in matched sectors of eyes without MvD. Multivariate linear regression analysis showed that the presence of MvD and greater MvD angular extent were independently associated with lower global pCVD in OAG eyes (all P < .05). Logistic regression analyses showed that lower pCVD was the only factor significantly associated with the presence of MvD. CONCLUSIONS: Localized MvD was a strong predictor of generalized pCVD loss within the beta-PPA in OAG eyes. (C) 2020 Elsevier Inc. All rights reserved.