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KMID : 1813520220110020067
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Journal of the Korean Glaucoma Society
2022 Volume.11 No. 2 p.67 ~ p.80
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Association between Choroidal Vessel Density Loss and Visual Field Progression in Normal Hemifield of Glaucomatous Eyes with Single-Hemifield Defect
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Lee An-Na
Sung Kyung-Rim
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Abstract
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Purpose : To investigate the hemifield measurements of parapapillary choroidal vessel density (pCVD) in open angle glaucoma (OAG) eyes with single-hemifield visual field defect (VFD) and their association with future VF progression in unaffected hemifield.
Methods : One hundred eyes of 100 OAG patients who presented VFD confined to single-hemifield (superior or inferior) were grouped into conversion and no conversion groups according to development of VFD in unaffected hemifield during follow-up period. Global and two hemiretinal (affected and unaffected) pCVD as well as superficial VDs in peripapillary and macular (cpVD and mVD) area were obtained using optical coherence tomography angiography (OCT-A) and compared between the conversion and no conversion group. Global and two hemiretinal circumpapillary retinal nerve fiber layer thickness and macular ganglion cell complex thickness (mGCCT) were also measured and compared between the two groups as the reference standard. Cox proportional hazard models were performed to identify risk factors of future VFD in unaffected hemiretina.
Results : Among 100 OAG eyes, 25 eyes (25.0%) showed VF conversion in unaffected hemifield. The conversion group showed significantly lower baseline pCVD, cpVD and mVD as well as thinner mGCCT at both affected and unaffected hemiretina compared to the no conversion group (p < 0.05). In our cox proportional hazard models, lower global and hemireitnal pCVD (global pCVD: hazard ratio [HR], 0.887; p = 0.014; affected pCVD: HR, 0.925; p = 0.022; unaffected pCVD: HR, 0.829; p = 0.005) and thinner global and unaffected hemiretinal mGCCT (global mGCCT: HR, 0.938; p = 0.026; unaffected mGCCT: HR, 0.942; p = 0.004) were the factors associated with future VFD in unaffected hemifield together with the presence of optic disc hemorrhage and choroidal microvasculature dropout.
Conclusions : Assessment of choroidal perfusion state using OCT-A may be useful to predict future VF progression toward the unaffected hemifield in OAG eyes with single-hemifield defect.
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KEYWORD
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Choriocapillaris, Deterioration, Glaucoma, Visual fields
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