Correlation of Peripapillary Vessel Density by OCTA with Visual Field Defects in Primary Open-Angle Glaucoma: A Cross-Sectional Study

Abstract

Glaucoma is one of the leading causes of irreversible blindness worldwide. Early detection is crucial for effective management. This study aims to evaluate the correlation between peripapillary vessel density as measured by optical coherence tomography angiography (OCTA) and visual field defects in patients with primary open-angle glaucoma (POAG). Methods: A prospective observational study was conducted at a tertiary care center and over a one-year duration. A total of 90 eyes from 48 already diagnosed POAG patients were included. OCTA was used to assess peripapillary vessel density, OCT was used for RNFL thickness, and Humphrey visual field analyzer (30-2, SITA Fast) for functional assessment. Results: Age distribution showed the highest incidence in patients over 60 years (34.4%). BCVA analysis showed 25.5% had 6/9 or better vision. Most patients (33.3%) had a CDR of 0.6. RNFL thickness was borderline (80–100 μm) in 42.2% and severely thinned (<60 μm) in 16.3%. MD was mild in 47.7%, moderate in 30%, and severe in 22.2%. Visual field defects included isopter contraction (21.1%), ring scotoma (16.6%), and inferior arcuate defects (7.7%). Vessel density was ≤40% in 44.4% of eyes. Strong correlations were found: Vessel Density vs. MD (r=0.9455), vessel density vs. CDR (r=-0.98), RNFL vs. CDR (r = -0.949), MD vs. CDR (r = -0.963). Conclusion: Peripapillary vessel density measured by OCTA is significantly correlated with structural (CDR, RNFL) and functional (MD) glaucoma parameters. OCTA serves as a valuable biomarker for glaucoma severity and progression.