Optical coherence tomography angiography vessel density parameters in primary open-angle glaucoma

Area of Science:

• Ophthalmology
• Medical Imaging
• Glaucoma Research

Background:

• Primary open-angle glaucoma (POAG) is associated with altered retinal hemoperfusion.
• Optical Coherence Tomography Angiography (OCT-A) offers non-invasive assessment of retinal microcirculation.
• OCT-A is a potential tool for early glaucoma diagnosis and monitoring.

Purpose of the Study:

• To evaluate the contribution of OCT-A vascular parameters in POAG.
• To assess the diagnostic capabilities of OCT-A in different glaucoma stages.
• To explore the role of vascular changes in glaucoma pathophysiology.

Main Methods:

• Prospective cross-sectional study with 200 control eyes and 250 glaucomatous eyes (early, moderate, advanced).
• Assessment included visual field (MD, LV), RNFL and GCC thickness (SS-OCT), and papillary/macular vascular densities (SS-OCT A).

Main Results:

• Glaucomatous eyes showed significantly lower OCT-A vessel densities in optic nerve head, peripapillary, and macular regions.
• Whole image vascular density demonstrated strong diagnostic ability (AUC: 0.949) for discriminating glaucoma.
• Vascular parameter diagnostic ability was slightly lower than structural RNFL (AUC: 0.981).
• Significant correlations found between structural, functional, and vascular parameters (r < 0.05).

Conclusions:

• OCT-A is valuable for early POAG diagnosis and follow-up.
• OCT-A enhances understanding of vascular contributions to glaucoma.
• OCT-A findings correlate with structural and functional glaucoma damage.