Visual Field of Eyes with Peripapillary Intrachoroidal Cavitation and Its Association with Deep Optic Nerve Head Structural Changes

PURPOSE: To evaluate the location-specific association of deep optic nerve head (ONH) structures and background characteristics with visual field (VF) sensitivity in eyes with peripapillary intrachoroidal cavitation (PICC). DESIGN: A prospective cross-sectional study. SUBJECTS: One hundred twenty-nine eyes of 93 consecutive cases with PICC determined on fundus photographs and confirmed on OCT. METHODS: Peripapillary intrachoroidal cavitation location was determined on ONH-centered OCT radial slices according to Garway-Heath sectors. Visual field defect (VFD) corresponding to the location of the PICC sector was considered absent when the pattern deviation probability plot showed no point with a probability < 1% within the corresponding 24-2 Humphrey VF sector. Sectoral mean total deviation (TD) was calculated for structure-function analysis. The presence of full-thickness retinal defect was determined, and PICC depth and deep ONH parameters were calculated with OCT slices. MAIN OUTCOME MEASURES: A best-fit multivariable linear mixed model was applied to identify factors associated with sectoral mean TD corresponding to PICC location. Explanatory variables included age, sex, axial length, intraocular pressure, presence of full-thickness retinal defect, circumpapillary retinal nerve fiber layer thickness (cpRNFLT), PICC depth, Bruch membrane opening (BMO) area, scleral flange opening (SFO) area, and SFO/BMO offset magnitude. RESULTS: Among 254 sectors with PICC, 136 sectors (54%) did not present corresponding VFD. Suspected VFD was most frequent in the temporal (34/50, 68%) and inferior temporal (67/104, 64%) sectors. In the best-fit multivariable analysis, worse sectoral TD in the PICC sectors was associated with the presence of full-thickness retinal defect (P = 0.036) and thinner cpRNFLT (P < 0.001) but was not associated with PICC depth or other deep ONH parameters. CONCLUSIONS: Although PICC alone did not necessarily cause corresponding VFD, PICC in the temporal sectors should be carefully examined for VFD. Full-thickness retinal defect, a myopia-induced tissue disruption, and cpRNFLT thinning at the PICC location were significantly associated with worse VF, whereas PICC size and other myopia-related deep ONH structural changes were not. Identification of these factors provides a foundation for understanding VF sensitivity reduction in eyes with characteristically highly myopic ONH changes. FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.