Correlating 10-2 Visual Field Loss with Structural and Angiographic Parameters in Advanced Glaucoma

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INTRODUCTION: We investigated the relationship between optical coherence tomography (OCT) angiography (OCTA)-derived vascular parameters, central visual field (10-2 VF), ganglion cell complex (GCC), and retinal nerve fiber layer (RNFL) thickness in patients with advanced glaucoma. METHODS: This retrospective, cross-sectional study included 28 eyes of 23 patients with advanced glaucoma (VF mean deviation [MD] worse than - 12 dB on 24-2 testing). All participants underwent comprehensive ophthalmic examinations, OCT, OCTA, and 10-2 VF tests. Pearson's correlation was used to assess relationships between structural, functional, and vascular parameters. RESULTS: Statistically significant positive correlations were found between GCC thickness and 10-2 VF MD (r = 0.529, p = 0.005), and between parafoveal superficial capillary plexus vessel density (SCP-VD) and 10-2 VF MD (r = 0.549, p = 0.002). Macular SCP vessel area density showed a positive correlation with RNFL thickness (r = 0.429, p = 0.036). Mean vessel length in the optic nerve head layer exhibited a negative correlation with 10-2 VF MD (r = - 0.528, p = 0.003). Quadrant-wise analysis revealed positive associations between SCP-VD and both GCC (r = 0.409, p = 0.038) and RNFL thickness (r = 0.410, p = 0.047) in the superior hemifield, and between deep capillary plexus vessel density and RNFL thickness (r = 0.533, p = 0.007) in the inferior hemifield. CONCLUSION: Parafoveal SCP-VD and GCC thickness, due to their significant correlations with 10-2 VF MD, may serve as surrogate markers for monitoring central visual function and disease progression in advanced glaucoma, particularly when reliable VF testing is not feasible.