Visual field of eyes with peripapillary intrachoroidal cavitation and its association with deep optic nerve head structural changes.
Objective: 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).
Methods: Prospective cross-sectional study. Methods: 129 eyes of 93 consecutive cases with PICC determined on fundus photographs and confirmed on optical coherence tomography (OCT). Methods: PICC location was determined on ONH-centered OCT radial slices according to Garway-Heath sectors. VF defect (VFD) corresponding to the location of PICC sector was considered absent when the pattern deviation probability plot showed no point with a probability less than 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. Methods: 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's 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 cpRNFL thinning at the PICC location were significantly associated with worse VF, while 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 characteristic highly myopic ONH changes.