Features of the Choroidal Microvasculature in Peripapillary Atrophy Are Associated With Visual Field Damage in Myopic Patients

PURPOSE: Optical coherence tomography angiography (OCT-A) was used to investigate the features of choroidal microcirculation within the beta-zone peripapillary atrophy (PPA) and its association with visual field (VF) defects in myopic patients. DESIGN: Cross-sectional study. METHODS: Participants: Eighty-four myopic patients with a unilateral glaucomatous VF defect. Observation Procedures: Comparison was performed between VF affected eyes and contralateral normal eyes. Area of a-zone PPA was measured on disc photographs and the choroidal map of OCT-A. The presence of regional microvasculature dropout (MvD) was defined as a complete loss of microvasculature in OCT-A images. Analyses were performed to investigate factors associated with the presence of VF defects or central VF defects within the 10-degree region. Main Outcome Measures: The beta-zone PPA area, OCT-A PPA area, and MvD detection percentage. RESULTS: The PPA area was greater in myopic eyes with VF defects compared to myopic eyes without VF defects (P=.039 and P=.027, respectively) on both disc photographs and OCT-A images. MvD was found significantly more frequently (77.4%) in glaucomatous eyes with central scotoma than in eyes without central scotoma (36.4%; P=.019). Larger PPA area on OCT-A than on disc photographs was independently associated with the presence of glaucomatous VF damage in myopic eyes. The presence of MvD was significantly associated with the presence of central scotoma in myopic eyes. CONCLUSIONS: Glaucomatous VF damage, especially central VF damage, was present in myopic eyes with a larger PPA or with the presence of MvD on the choroidal map of OCT-A. (C) 2018 Elsevier Inc. All rights reserved.