Optic Disc Vessel Density Helps Reveal Glaucoma Progression Early

After capturing OCT-A images, an evaluation of the ratio of pixels observed at the vessels within the temporal optic disc can calculate and assist with monitoring optic disc vessel density. (Image from a different study.) Photo: Lee MW, et al. Sci Rep. June 7, 2023. Click image to enlarge. OCT continues to serve as an invaluable tool in eye care as another study, published in American Journal of Ophthalmology, reported findings that could help monitor the progression of disease in patients with primary open-angle glaucoma (POAG).For this study, researchers separated subjects into groups based on disease severity, recorded visual field (VF) changes over time, and observed OCT and OCT angiography (OCT-A) findings in relation to recorded changes. They focused their observation on the optical disc vessel density of each patient. Using OCT-A, reductions in vessel density can be detected. If a relationship between vessel density reductions and VF changes presents itself, then this biomarker could determine progression of glaucoma at varying levels of severity, researchers hypothesized.In this study, researchers observed 345 POAG cases. Patients were categorized based on visual field mean deviation (MD) as follows:Early stage (MD ≥ -6 dB; n=153)Moderate stage (MD -12 dB to -6 dB; n=98)Advanced stage (MD < -12 dB; n=94)Over a minimum of three years, researchers discovered that optic disc vessel density reduction rates for VF progressors was significantly faster than in nonprogressors across all three severity stages. This progression was associated with global vessel density change. Odds ratios for the association between VF progression and either the rate of global ODVD change or binary ODVD reduction were the highest among advanced cases (odds ratios of 1.48 and 14.0, respectively). The researchers also found a significant association between both rates of change and reduction with VF progression in early and moderate-to-advanced glaucoma.“Despite visual field typically being regarded as the gold standard for monitoring progression,” wrote the researchers in their paper, “it presents limitations due to high long-term fluctuation, particularly in advanced stages. Our findings suggested approximately 0.3 to 0.5 years more rapid detection of ODVD reduction compared to visual field progression, which could indicate that changes in optic disc microvasculature serve as early markers of disease worsening. Therefore, close follow-up and early intervention may be needed for advanced POAG patients with progressive ODVD reduction to prevent vision loss.”Click here for the journal source. Suh MH, Weinreb RN, Hallaj S, Zangwill LM. Optic disc microvasculature reduction and visual field progression in advanced primary open-angle glaucoma. Am J Ophthalmol. March 28, 2026. [Epub ahead of print]. This article was developed by the editorial staff in conjunction with experts in the field. In the process, AI may have been among the editorial tools used to meet the goals of human editors, who approved all content.