Steeper Structure-function Relationship in Eyes with Than Without a Parapapillary Deep-layer Microvasculature Dropout

The degree of visual field (VF) loss can vary widely at a given level of retinal nerve fiber layer (RNFL) thickness. The cause of this variability is not fully understood. This cross-sectional study investigated whether the presence of choroidal microvasculature dropout (MvD) influences on the structure-function relationship among glaucomatous eyes. Seventy-one primary open-angle glaucoma (POAG) patients with choroidal MvD as determined by optical coherence tomography angiography (MvD+ group), and 71 age- and inferotemporal (IT) RNFL thickness-matched POAG patients without MvD (MvD- group) were included. VF sensitivity within the region corresponding to the IT RNFL sector was averaged using the total and pattern deviation fields. The slope of log-scale RNFL thickness versus VF defect was significantly steeper for the MvD+ than the MvD- group, as determined by both total and pattern deviation maps (P = 0.004 and <0.001, respectively). Both total and pattern VF deviation were significantly worse in the MvD+ than in the MvD- group (P = 0.002 and 0.007, respectively). Same results were obtained in subgroup analyses for eyes with thick and thin RNFL thickness (all P ≤ 0.027). These data suggest that parapapillary MvD is associated with poorer function of the remaining axons in eyes with POAG.