Hemisphere opposite to central retinal vascular trunk deviation is earlier affected by glaucomatous damage in primary angle‐closure glaucoma. Issue 2 (22nd September 2022)

• Record Type: Journal Article
• Authors: Oh, Richul; Lee, Kyoung Min; Kim, Martha; Oh, Sohee; Kim, Seok Hwan
• Is Part Of: Acta ophthalmologica. Volume 101:Issue 2(2023)
• Page Start: e252
• Page End: e260
• Publication Date: 2022-09-22
• Subjects: angle‐closure glaucoma -- Bruch's membrane opening -- externally oblique border -- lamina cribrosa -- offset; Ophthalmology -- Periodicals; 617.7005
• DOI: 10.1111/aos.15258
• Languages: English
• ISSNs: 1755-375X

Abstract

Abstract: Purpose: The purpose of the study was to investigate whether the position of the central retinal vascular trunk (CRVT), as a surrogate for lamina cribrosa (LC) offset, is associated with the dominant hemisphere of visual field defect in primary angle‐closure glaucoma (PACG) eyes. Methods: Central retinal vascular trunk deviation was measured from Bruch's membrane opening (BMO) centre, which was delineated by OCT imaging, using the horizontal midline as a reference. The dominant hemisphere developing visual field defect was defined as three connected abnormal points (having a p ‐value < 5% probability of being normal) appearing in only one hemisphere or each point of the hemisphere having a statistically worse value compared with its mirrored point in the opposite hemisphere on pattern deviation plots. Results: One hundred five (80%) of 132 eyes with PACG had dominant hemisphere of visual field defect initially: 70 eyes (67%) in the superior and 35 eyes (33%) in the inferior hemisphere. The CRVT was located superiorly in the dominant superior visual field defect group ( p < 0.001). A logistic regression analysis revealed that superior deviation of the CRVT was the only factor associated with dominant superior visual field defect ( p < 0.001). Externally oblique border (EOB) presence was associated with larger BMO ( p = 0.005) and angular deviation of CRVT ( p = 0.002). Conclusions: Central retinal vascular trunk deviation was associated with the dominant hemisphere of visual field defect in PACG eyes. This finding implies that the LC position relative to the BMO centre (LC/BMO offset) may incur structural vulnerability in the optic nerve head of PACG eyes.