For a study, the researchers sought to find the factors influencing wedge deficiencies in peripapillary OCTA in glaucoma. Between 2016 and 2020, 278 eyes of 186 participants with mild to severe primary open-angle glaucoma were subjected to 66 spectral-domain OCTA imaging of the superficial peripapillary retina at an academic practice. Wedge defects were characterized as a loss of focal microvasculature that extended in an arcuate wedge form outward from the optic nerve. Variables strongly linked with wedge flaws were identified using logistic regression models that controlled for intereye correlation. Eyes with severe microvascular loss in both hemispheres were eliminated from the study. Age, sex, race or ethnicity, diabetes, hypertension, follow-up duration, baseline untreated intraocular pressure, intraocular pressure at imaging, DH history, paracentral VF defects, CDR, central corneal thickness, spherical equivalent, VF mean deviation, RNFL thickness, and glaucoma stage were among the candidate variables. Wedge abnormalities were seen in at least 1 hemisphere in 126 (45.3%) of the 278 eyes studied. Wedge defects were linked to DH history [odds ratio (OR): 3.19, 95% CI: 1.05–9.69, P=0.041], paracentral VF defects [OR: 4.38 (95% CI: 2.11–9.11), P<0.0001], larger CDR [OR: 1.27 (95% CI: 1.03–1.56), P=0.024, per 0.1 increase], and thinner RNFL [OR: 1.71 (95% CI:1.25–2.34), P=0.0009, per 10 μm decrease]. Wedge deficiencies on OCTA were independently linked with DH history and paracentral VF defects, presented in 45.3% of primary open-angle glaucoma patients. These discoveries shed light on the pathophysiology of glaucoma.
