Association of contrast sensitivity with vessel density and functional parameters in different stages of glaucoma.

Purpose: To evaluate the association between contrast sensitivity (CS), vessel density (VD), and functional parameters in patients with glaucoma of varying severity.

Methods: Ninety-four eyes of 94 patients (57 men and 37 women, aged 56.52 ± 11.28 years) were divided into mild and moderate to advanced glaucoma groups. The mild glaucoma group was further subdivided based on the presence of central visual field defect (CVFD). Pearson's correlations were used to evaluate the associations between area under the log CS function (AULCSF), best-corrected visual acuity (BCVA), 10 - 2 visual field (VF), and structural parameters, including VD. The area under the receiver operating characteristic (AUROC) curve was calculated to detect abnormal CS (AULCSF < 1.2).

Results: In mild glaucoma without CVFD, AULCSF was associated with radial peripapillary capillary VD (γ = 0.597, P = 0.001), with an AUROC of 0.840 (P = 0.006) for detecting abnormal CS. In mild glaucoma with CVFD, AULCSF worsened and was associated with superficial parafoveal VD (γ = 0.569, P = 0.017) and macular whole image VD (γ = 0.632, P = 0.007), with AUROCs of 0.833 (P = 0.021) and 0.792 (P = 0.043), respectively. In moderate to advanced glaucoma, the relationship between AULCSF and the mean deviation of 10 - 2 VF and BCVA was more robust than that observed in structural measures.

Conclusions: Decreased VD is linked to early CS impairment. Radial peripapillary capillary and macular VD can serve as indicators of CS function in the early stages of glaucoma. KEY  MESSAGES: What is known Contrast sensitivity loss has been reported in glaucoma patients but its relationship with glaucoma-related structural and functional changes in different glaucoma severity and central visual field defect (CVFD) remains elusive. What is new Decline in RPC peripapillary vessel density was associated with early impairment of contrast sensitivity in mild glaucoma without CVFD. Decline in macular vessel density and central 16 points of 10-2 visual field damage were associated with contrast sensitivity reduction in mild glaucoma with CVFD. Microvasculature change can serve as an indicator for abnormal contrast sensitivity.