![]() However, limited information is available on differences in superficial macula microvasculature damage between superior and inferior hemifields in glaucoma patients. Macular retinal layer thickness asymmetry indices, particularly for the ganglion cell layer, are promising early indicators of glaucomatous retinal damage 10, 13. The glaucoma hemifield test (GHT) of the VF, which measures disparity in retinal sensitivity between the superior and inferior hemifields, is regarded as a useful tool in glaucoma assessment 11, 12. The thicknesses of the cpRNFL, mGCIPL, and ganglion cell complex (GCC) in normal eyes are highly symmetrical in the upper and lower retinal hemispheres 9, 10. Studies have even revealed that OCTA vascular density parameters have stronger correlations with VF defects than do OCT structural parameters 7, 8. Researchers have used OCTA to quantify the density of perfused vessels in peripapillary and macular regions in glaucoma patients, and increasing evidence has shown strong correlations between vessel density measurements and cpRNFL defects, visual field (VF) deficits, and glaucoma severity 5, 6, 7, 8. Optical coherence tomography angiography (OCTA) is a newly developed noninvasive imaging modality that provides for qualitative and quantitative evaluation of the microvasculature of different retinal layers. 2 reported that macular ganglion cell layer–inner plexiform layer (mGCIPL) changes are detected even before corresponding cpRNFL changes in the optical coherence tomography (OCT) deviation map. Increasing evidence implicates early macular involvement in glaucomatous damage 1, 2, 3, and it has been highlighted that cpRNFL analysis alone is insufficient for detecting macular damage 4. MPDA may be helpful in monitoring glaucoma progression in clinical practice.Įvaluation of the circumpapillary retinal nerve fibre layer (cpRNFL) is useful for glaucoma diagnosis however, more than 50% of retinal ganglion cell somas are located within the macula. In conclusion, the discriminant capability of MPDA for discriminating between glaucoma patients with and without VF defects is significantly higher than that of structural asymmetry. Outer MPDA had significantly higher discrimination ability between PPG and PG than did macular ganglion cell layer–inner plexiform layer thickness asymmetry (p = 0.039). Asymmetry of perfusion density and structural parameters was compared no significant difference was found between controls and glaucoma patients. However, outer MPDA was significantly higher in the PG group than in the PPG group (p = 0.009). No significant difference was found in outer and inner MPDA between the control and PPG groups. In this study, 116 eyes (39 normal, 27 PPG, and 50 PG eyes) with optical coherence tomography angiography images of the macula were analysed. We evaluated macular perfusion density asymmetry (MPDA) among normal, preperimetric glaucoma (PPG), and perimetric glaucoma (PG) eyes, and we tested the performance of MPDA in differentiating between control and glaucoma eyes with or without visual field (VF) defects. Macular retinal layer thickness asymmetry indices, particularly for the ganglion cell layer, are promising early indicators of glaucomatous damage.
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