Association of macular OCT and OCTA parameters with visual acuity in glaucoma

Br J Ophthalmol. 2023 Nov;107(11):1652-1657. doi: 10.1136/bjo-2022-321460. Epub 2022 Sep 9.

Abstract

Background/aims: To investigate the association of macular optical coherence tomography (OCT)/OCT angiography (OCTA) parameters with visual acuity (VA) in glaucoma.

Methods: 144 pseudophakic primary open-angle glaucoma eyes were included. Foveal (fVD), parafoveal (pf), perifoveal (perifVD) and whole-image vessel densities (wiVD) of superficial and deep layers, and their corresponding ganglion cell complex (GCC) thicknesses were obtained from OCTA 6×6 mm2 macula scans. Foveal avascular zone (FAZ) area, FAZ circumference and foveal density-300 (FD300) were measured. Correlation between OCT/OCTA parameters and Logarithm of the Minimum Angle of Resolution VA (logMAR VA) in early and moderate-advanced glaucoma was evaluated with age and Signal Strength Index-adjusted mixed models. Area under receiver operating characteristic (AUC) was used to evaluate discriminative power of OCT/OCTA for decreased VA (<20/25).

Results: In early glaucoma (80 eyes), no parameter correlated with VA. In moderate-advanced glaucoma (64 eyes), greater FAZ area (β=0.228) and circumference (β=0.063) correlated with worse VA (p<0.05), but not FD300. fThinner sectoral and global GCC was associated with worse VA (β=0.002-0.003, p<0.05), except for inferior hemifield perifGCC and wiGCC. For VD, lower superior hemifield superficial perifVD and wiVD (β=0.007-0.008) and deep fVD (β=0.004) correlated with worse VA (p<0.05). OCT/OCTA parameters showed modest ability to discriminate decreased VA, with the superior hemifield performing better than the inferior hemifield. In early glaucoma, GCC and VD showed similar discrimination (AUC=0.67-0.77). In moderate-advanced glaucoma, fGCC and pfGCC yielded higher AUC (0.75-0.81) than VD (AUC=0.63-0.72).

Conclusions: Some macular OCT/OCTA parameters were associated with VA in moderate-advanced, but not early glaucoma. These structural parameters may help identify glaucoma patients with impaired vision and reduced quality of life.

Trial registration number: NCT00221897.

Keywords: Glaucoma; Vision.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Fluorescein Angiography / methods
  • Glaucoma* / diagnosis
  • Glaucoma, Open-Angle* / diagnosis
  • Humans
  • Quality of Life
  • Retinal Vessels
  • Tomography, Optical Coherence / methods
  • Visual Acuity

Associated data

  • ClinicalTrials.gov/NCT00221897