Retinal Vascular Fingerprints as Novel Biomarkers for Primary Angle Closure Disease Progression

Area of Science:

• Ophthalmology
• Vascular Biology
• Glaucoma Research

Background:

• Primary angle-closure disease (PACD) encompasses a spectrum from suspect to glaucoma.
• Understanding retinal vascular changes across PACD stages is crucial for diagnosing and managing associated glaucomatous optic neuropathy (GON).

Purpose of the Study:

• To evaluate retinal vascular parameters in different stages of PACD.
• To explore the association between these retinal vascular parameters and GON.

Main Methods:

• A cross-sectional study involving 638 eyes from 425 participants aged ≥40 years with PACD.
• Retinal vascular parameters were measured using the Retinal-based Microvascular Health Assessment System.
• Multivariable logistic mixed effects models identified factors associated with GON.

Main Results:

• No significant differences in retinal vascular parameters were observed between primary angle closure suspect (PACS) and primary angle closure (PAC) groups.
• Eyes with primary angle closure glaucoma (PACG) exhibited significant vascular changes compared to PACS (P < 0.05).
• Elevated intraocular pressure and specific vascular geometric parameters (tortuosity, fractal dimension, branching angle, asymmetry ratio) were independently associated with GON.

Conclusions:

• Retinal vascular geometric alterations are present in PACG and are independently associated with GON.
• These findings highlight the role of vascular changes in GON and suggest potential for novel diagnostic markers.
• Further longitudinal studies are warranted to confirm prognostic value and clinical utility in PACD management.