Relationship of 24-2C Central Visual Field Damage to Juxtapapillary Choriocapillaris Dropout in Glaucoma Eyes With or Without Axial Myopia

Abstract

Purpose: To evaluate the relationship between a juxtapapillary choriocapillaris microvasculature dropout (MvD) and central visual field (VF) damage in primary open-angle glaucoma (POAG) patients with or without axial myopia. Methods: This cross-sectional study included 125 patients with POAG or glaucoma suspects stratified into no axial myopia (axial length (AL) < 24 mm; 46 eyes), mild axial myopia (24 mm< AL < 26 mm; 81 eyes), and high axial myopia (AL > 26 mm; 59 eyes). Presence, area, and angular circumference of juxtapapillary MvD were evaluated on OCT-A en-face choroidal images and B-scans. Perimetry was conducted using the 24-2C and 10-2 Humphrey program. Results: Mean 24-2C VF mean deviation was significantly worse in eyes with MvD compared to eyes without MvD across all groups (all p<0.042). Central VF defects detected in the 24-2C and 10-2 VF tests were significantly more prevalent among eyes with MvD (68.3% and 81.7%, respectively) compared to eyes without MvD (19.0% and 38.1%, respectively) (p < 0.001) in the mild axial myopia group. In multivariable analysis, larger MvD area (p=0.014) and wider MvD angular circumference (p=0.006) were significantly associated with higher likelihood of the presence of 24-2C central VF damage in overall cohort. Conclusions: MvD area and angular circumference are significantly associated with central VF damage detected by VF 24-2C in POAG eyes with and without axial myopia. Choriocapillaris MvD assessment shows promise for identifying POAG patients with a higher risk of having central VF defects and may provide clinical insights into the pathogenesis of glaucoma in myopia.