Behavior of Visual Field Index in Advanced Glaucoma

Rao, Harsha L.; Senthil, Sirisha; Choudhari, Nikhil S.; Mandal, Anil K.; Garudadri, Chandra S.

doi:10.1167/iovs.12-10836

Cited by 37 publications

(27 citation statements)

References 19 publications

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“…Recent reports suggest that standard structural measures such as RNFL thickness reach a floor effect and visual field tests are highly variable in eyes with advanced glaucoma. 11, 39-42 It is important to evaluate whether OCT-A has a sufficient dynamic range to provide clinically relevant information across the full spectrum of glaucoma severity. In addition, we did not evaluate the possible confounding impact of various systemic conditions, blood pressure and perfusion pressure, glaucoma eye drops, and systemic medications on vessel density and its relationship to standard structural and functional measures.…”

Section: Discussionmentioning

confidence: 99%

Relationship between Optical Coherence Tomography Angiography Vessel Density and Severity of Visual Field Loss in Glaucoma

et al. 2016

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Purpose To evaluate the association between vessel density measurements using optical coherence tomography angiography (OCT-A) and severity of visual field loss in primary open-angle glaucoma (POAG) Design Observational cross-sectional study Participants One hundred and fifty three eyes from 31 healthy, 48 glaucoma suspects, and 74 glaucoma participants enrolled in the Diagnostic Innovations in Glaucoma Study Methods All eyes underwent imaging using an OCT-A (Angiovue, Optovue; Fremont, CA) and a spectral domain OCT (Avanti, Optovue; Fremont, CA), along with standard automated perimetry (SAP). Retinal vasculature information was summarized as vessel density, the percent of area occupied by flowing blood vessels in the selected region. Two measurements from the retinal nerve fiber layer (RNFL) were utilized: circumpapillary vessel density (cpVD) (750-μm-wide elliptical annulus around the optic disc); and whole image vessel density (wiVD) (entire 4.5 × 4.5 mm scan field) Main Outcome Measures Associations between severity of visual field loss, reported as SAP mean deviation (MD) and OCT-A vessel density Results Compared to POAG eyes, normal eyes demonstrated a denser microvascular network within the RNFL. Vessel density was higher in normal eyes followed by glaucoma suspects, mild glaucoma and moderate to severe glaucoma eyes for wiVD (55.5, 51.3, 48.3, 41.7% respectively) and for cpVD (62.8, 61.0, 57.5, 49.6% respectively) (P<0.001 for both). The association between the severity of visual field damage (MD) with cpVD and wiVD was stronger (R2=0.54, and R2=0.51 respectively) than the association between visual field MD and RNFL (R2=0.36) and rim area (R2=0.19) (P<0.05 for all). Multivariate regression analysis, adjusted for confounders, showed that each 1% decrease in cpVD was associated with 0.64 dB loss in MD and each 1% decrease in wiVD, was associated with 0.66 dB loss in MD. In addition, the association between vessel density and the severity of visual field damage was found to be significant even after controlling for the effect of structural loss Conclusions Decreased vessel density was significantly associated with severity of visual field damage independent of the structural loss. OCT-A is a promising technology in glaucoma management, potentially enhancing the understanding of vascular role in the pathophysiology of the disease

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Section: Discussionmentioning

confidence: 99%

Relationship between Optical Coherence Tomography Angiography Vessel Density and Severity of Visual Field Loss in Glaucoma

et al. 2016

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“…Considering the range of VF sensitivity at which a RNFL floor begins, VF tests have been preferred to pRNFLT measurements at the moderate-to-advanced stage of glaucoma for follow-up 12. However, the VF test sometimes shows large fluctuations in patients with advanced glaucoma, rendering it difficult to define actual glaucomatous change 19. By contrast, structural/vascular assessment is not dependent on patient response and may thus yield less variable results if the technology used offers good reproducibility.…”

Section: Discussionmentioning

confidence: 99%

Regional vascular density–visual field sensitivity relationship in glaucoma according to disease severity

et al. 2017

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“…This suggests that the VFI is likely insensitive for detecting early visual field loss. Additionally, due to the change in the VFI algorithm, in visual field series in which MD crosses À20 dB, there is a stepwise worsening in VFI and an increase in its variability, reducing the reliability of VFI in these cases (Lee et al, 2014;Rao et al, 2013; Fig. 1).…”

Section: Global Trend Analysismentioning

confidence: 99%

How to detect progression in glaucoma

Vianna

Chauhan

2015

Progress in Brain Research

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Behavior of Visual Field Index in Advanced Glaucoma

Abstract: The decrease in VFI when MD crosses -20 dB can be highly variable. This has to be considered with the use of VFI in clinical and research settings.

Cited by 37 publications

References 19 publications

Relationship between Optical Coherence Tomography Angiography Vessel Density and Severity of Visual Field Loss in Glaucoma

Relationship between Optical Coherence Tomography Angiography Vessel Density and Severity of Visual Field Loss in Glaucoma

Regional vascular density–visual field sensitivity relationship in glaucoma according to disease severity

How to detect progression in glaucoma

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