Inferior VF Progression Linked to Superior Retinal Artery Angular Position in POAG

Man Undergoing a Visual Field Test
Senior female Doctor Checking male Patient’s Eyes Using Retinal Scanner.
A study shows an association between disease progression in the inferior VF and superior retinal artery angular positioning.

The progression of the inferior visual field (VF) is associated with the superior retinal artery angular position in patients with primary open-angle glaucoma (POAG), according to research published in Investigative Ophthalmology and Visual Science.

To investigate the association between glaucomatous changes to the visual field and retinal structures, such as the position of the optic disc and major retinal arteries, investigators examined 116 eyes of 73 patients with POAG. The relationship between sectorial total deviation progression rate and 8 variables — age, mean and standard deviation of intraocular pressure (IOP) during the observation period, baseline sectorial total deviation value, papillomacular bundle tilt angle, axial length, and superior and inferior arterial angle — were each investigated.

The team found that the main outcome measures were the associations between retinal structural parameters and the glaucomatous progression of VF. The superior retinal artery angular position was positively associated with sectorial total deviation progression rates in 2 central sectors in the inferior hemifield, suggesting faster VF progression where superior retinal artery angles are narrow. Papillomacular bundle tilt was not associated with the total deviation progression rate in any sector.

“A narrow superior arterial angle was associated with faster VF progression in 2 sectors (sectors 1 and 2) and a wider inferior artery angular position was associated with more rapid VF progression in one sector (sector 5). Papillomacular bundle tilt angle was not associated with VF progression rate in any sector,” the study explains.

The study also suggests that mean IOP has limited influence on disease progression rates, and that it was only an important variable to explain progression in 2 sectors (sectors 3 and 5).

The study’s limitations include that VF assessments were conducted using 24-2, not 10-2 tests, and that analyses were not conducted in the temporal VF areas.


Fujino Y, Asaoka R, Murata H, et al. The relationship between optic disc and retinal artery position and glaucomatous visual field progression. Invest Ophthalmol Vis Sci. 2021;62(12):6.