Longitudinal Changes in Peripapillary and Macular Vessel Densities in Glaucomatous Eyes with a Single-Hemifield Retinal Nerve Fiber Layer Defect.

PRECIS: The peripapillary vessel density decreased significantly in the affected hemiretina compared to that in the intact hemiretina in glaucomatous eyes with a single-hemifield retinal nerve fiber layer defect.

PURPOSE: To evaluate the difference in the change rates of peripapillary vessel density (pVD) and macular vessel density (mVD) measured using optical coherence tomography angiography (OCTA) in glaucomatous eyes with a single-hemifield retinal nerve fiber layer (RNFL) defect.

METHODS: We performed a retrospective, longitudinal study of 25 patients with glaucoma who were followed up for at least 3 years, with a minimum of four visits after baseline OCTA. At each visit, all participants underwent OCTA examination, and the pVD, mVD were measured by removing the large vessels. Changes in the pVD, mVD, peripapillary RNFL thickness (pRNFLT), and macular ganglion cell inner plexiform layer thickness (mGCIPLT) were investigated in the affected and intact hemispheres, and the differences between the two hemispheres were compared.

RESULTS: In the affected hemiretina, the pVD, mVD, pRNFLT, and mCGIPLT were reduced than that in the intact hemiretina (all, P < 0.001). The changes in pVD and mVD were statistically significant at the 2-year and 3-year follow-ups in the affected hemifield (-3.37%, -5.59%, P=0.005, P < 0.001). However, pVD and mVD did not show statistically significant changes in the intact hemiretina throughout the follow-up visits. While the pRNFLT decreased significantly at the 3-year follow-up, the mGCIPLT showed no statistical change at any follow-up visit. Compared to the intact hemisphere, pVD was the only parameter that showed significant changes throughout the follow-up period.

CONCLUSION: Although pVD and mVD decreased in the affected hemiretina, the reduction in pVD was significant compared to that in the intact hemiretina.