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목적 : The central visual field (VF) damage is important in glaucoma patients as it associates with significant deterioration in vision-related quality of life. Therefore, it is crucial to uncover the factors that may exacerbate the central VF damage in glaucoma. Choroidal Microvasculature Dropout (CMvD) is known to be associated with involvement of parafoveal VF defects. This study aims to investigate the impact of the presence of CMvD on the rates of regional VF areas, particularly in the Central VF, using glaucoma hemifield test (GHT) and parafoveal vs. peripheral zone maps.
방법 : Open-angle glaucoma (OAG) eyes having a minimum of 5 eligible 24-2 VF tests were included. The patients were divided into two groups: eye with CMvD and those without CMvD assessed by optical coherence tomography angiography image. The global and regional VF progression rates were calculated using a linear mixed model. Kaplan-Meier survival analysis and log-rank test were used to compare the cumulative risk ratio of central VF progression between two groups. Risk factors for central VF progression were evaluated using Cox proportional hazard models in OAG eyes.
결과 : A total 118 eyes with 76 OAG patients were enrolled. Fifty-five eyes had CMvD, and 63 eyes had no CMvD. Although there was no significant difference in global VF progression rate between two groups, there were statistically significant differences in regional VF progression rates as assessed by Kaplan-Meier analysis (log-rank test, P< 0.05). Patients with CMvD exhibited significantly faster central VF progression rates than those without CMvD. The presence of CMvD was a factor associated with progressive central VF defects in multivariate analysis using a mixed model.
결론 : Eyes with CMvD exhibited more rapid central VF defect progression than those without CMvD. Observation of CMvD in OAG eyes may suggest rapid central VF defect progression and warrants more vigilant surveillance and aggressive treatment.
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