Correlation of optic nerve hemoglobin levels with structural and functional parameters in glaucoma

Glaucoma is a chronic and progressive eye disease that leads to irreversible damage to the optic nerve and retinal nerve fiber layer, resulting in visual field loss. Abnormalities in retinal blood flow and vascular regulation are increasingly recognized as key factors in glaucoma development. This study explores the relationship between optic nerve head hemoglobin (ONH Hb) levels, assessed through automated colorimetric analysis using Laguna ONhE software, and structural and functional parameters in glaucoma patients. The study included 57 glaucoma patients (89 eyes) and evaluated correlations between ONH Hb levels, retinal nerve fiber layer thickness (RNFLT), ganglion cell layer thickness (GCLT), foveal avascular zone (FAZ) metrics, and visual field indices. Results showed significant correlations between ONH Hb levels and visual field mean defect, RNFLT, and GCLT, highlighting the potential of ONH Hb as a non-invasive marker for glaucoma-related structural changes. The findings suggest that ONH Hb assessment could serve as a practical and cost-effective tool for glaucoma diagnosis and monitoring, particularly in settings where advanced imaging technologies like OCT and OCTA are less accessible. This study underscores the importance of vascular factors in glaucoma and supports the use of ONH Hb evaluation as a complementary approach to traditional diagnostic methods.