Background/aims To investigate the association between longitudinal changes of foveal avascular zone (FAZ) area and the rate of structural and functional progression in glaucoma. Methods A longitudinal cohort included 115 eyes (46 glaucoma suspect and 66 primary open-angle glaucoma) of 81 patients having ≥2 year follow-up, and ≥4 visits with optical coherence tomography angiography and visual field (VF). Eyes in the longitudinal cohort with a slope greater than that found in 95 percentile of separate healthy test–retest series for FAZ area were categorised into FAZ progressors; all other eyes were defined as FAZ non-progressors. A generalised linear mixed-effect model was used to investigate the association of FAZ progressors with demographic and clinical characteristics. Results Faster ganglion cell complex (GCC) thinning and faster VF mean deviation (MD) loss were found in eyes with FAZ progressors compared with FAZ non-progressors (mean difference: −0.7 (95% CI, −1.4 to −0.1) µm/y; p=0.026, −0.3 (−0.5 to −0.1) dB/y; p=0.017, respectively), while whole image vessel density was not associated with FAZ progressors (p=0.929). SD of intraocular pressure (IOP) and IOP range were also associated with FAZ progressors in separate multivariable models (OR: 1.54 (1.02 to 2.32) per 1 mm Hg higher, p=0.041; OR: 1.20 (1.01 to 1.41) per 1 mm Hg higher; p=0.035, respectively). Conclusions Significant FAZ increase was weakly associated with moderately faster rates of both GCC thinning and VF MD loss, but not macular vessel density change in glaucoma eyes. Additional studies are needed to elucidate the pathophysiological associations between macula GCC thinning and FAZ area increases in glaucoma. Data are available upon request.

中文翻译：

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黄斑中心凹无血管区变化与青光眼进展的关联


背景/目的 探讨青光眼黄斑中心凹无血管区 (FAZ) 面积的纵向变化与结构和功能进展率之间的关联。方法 纵向队列包括 81 名患者的 115 只眼睛（46 只疑似青光眼和 66 只原发性开角型青光眼），随访时间≥2 年，并且进行光学相干断层扫描血管造影和视野 (VF) 就诊次数≥4 次。纵向队列中斜率大于 FAZ 区域单独健康测试-再测试系列的 95% 的斜率的眼睛被归类为 FAZ 进展者；所有其他眼睛被定义为 FAZ 非进展者。使用广义线性混合效应模型来研究 FAZ 进展者与人口统计学和临床​​特征的关联。结果 与 FAZ 非进展者相比，FAZ 进展者眼睛的神经节细胞复合体 (GCC) 变薄更快，VF 平均偏差 (MD) 损失更快（平均差：-0.7（95% CI，-1.4 至 -0.1）μm/ y；p=0.026、-0.3（-0.5 至 -0.1）dB/y；p=0.017），而整个图像血管密度与 FAZ 进展无关（p=0.929）。在单独的多变量模型中，眼压 (IOP) 和 IOP 范围的 SD 也与 FAZ 进展者相关（OR：每升高 1 mm Hg，1.54（1.02 至 2.32），p=0.041；OR：每升高 1 mm，1.20（1.01 至 1.41）。 Hg 较高；p=0.035）。结论 FAZ 的显着增加与 GCC 变薄和 VF MD 损失的较快速度有微弱的相关性，但与青光眼眼中黄斑血管密度的变化无关。需要更多的研究来阐明青光眼中黄斑 GCC 变薄和 FAZ 面积增加之间的病理生理学关联。数据可根据要求提供。