Structural, Vascular, and Functional Correlations in Advanced Glaucoma.

Abstract

Purpose: To evaluate the correlation between structural tests - optical coherence tomography (OCT) and OCT angiography (OCTA) - and the functional visual field test (VFT) in patients with advanced-stage glaucoma.

Methods: This retrospective observational study included patients with a mean deviation (MD) worse than -12 dB on the 24-2 VFT. Patients with a history of intraocular surgery within the previous 6 months or with unreliable OCT, OCTA, or VFT results were excluded. For each patient, best-corrected visual acuity (BCVA), retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) thickness (via OCT), radial peripapillary capillary vessel density (VD) of the optic disc, and superficial/deep macular VD (via OCTA) were assessed. Functional parameters included MD and pattern standard deviation from VFT. Correlations between structural and functional parameters were analyzed.

Results: The study included 31 eyes of 20 patients (mean age: 68.81 ± 8.19 years; 65% male). Diagnoses per eye were pseudoexfoliative glaucoma (n = 14), primary open-angle glaucoma (n = 11), normal-tension glaucoma (n = 4), and pigmentary glaucoma (n = 2). The mean MD was -16.78 ± 7.46 dB. Moderate correlations were found between RNFL and GCC thicknesses, peripapillary and macular VD, and visual field indices. BCVA was also correlated with superior RNFL, GCC, and OCTA values.

Conclusions: Significant correlations exist between structural and functional tests in advanced glaucoma. Combined use of OCT, OCTA, and VFT provides a more holistic and effective approach in disease monitoring and management.