Optical Microangiography and Progressive Retinal Nerve Fiber Layer Loss in Primary Angle Closure Glaucoma

Area of Science:

• Ophthalmology
• Glaucoma Research
• Retinal Imaging

Background:

• Primary angle closure glaucoma (PACG) is a leading cause of irreversible blindness globally.
• Retinal nerve fiber layer (RNFL) thinning is a hallmark of glaucoma progression.
• Optical microangiography (OMAG) offers novel insights into ocular microvasculature.

Purpose of the Study:

• To investigate the association between OMAG parameters and RNFL loss in mild to moderate PACG.
• To identify clinical predictors of RNFL progression in PACG patients.

Main Methods:

• Prospective longitudinal study of 30 PACG patients (45 eyes) over 2 years.
• Baseline OMAG imaging and serial optical coherence tomography (OCT) for RNFL assessment.
• Linear mixed models used to evaluate associations between clinical/OMAG parameters and RNFL change rate.

Main Results:

• Younger patient age and higher peak intraocular pressure (IOP) during follow-up were significantly associated with faster RNFL loss.
• No significant association was found between baseline OMAG parameters (peripapillary and macular perfusion density) and the rate of RNFL loss.
• The average rate of RNFL change was -2.5±1.7 µm/year.

Conclusions:

• Younger age and elevated peak IOP are significant predictors of RNFL progression in mild to moderate PACG.
• Baseline OMAG parameters do not appear to predict structural progression in this patient cohort.
• Further research may be needed to explore the role of OMAG in different stages or types of glaucoma.