Effect of Intraocular Pressure Lowering Treatment on Peripapillary and Macular Vessel Density on Normotensive Eyes...

To evaluate the effect of intraocular pressure (IOP) reduction on peripapillary and macular vessel density parameters from optical coherence tomography angiography (OCT-A) in normotensive eyes with optic disc drusen (ODD). Randomized controlled trial, with 6 months of follow-up, including normotensive eyes with ODD divided into two groups: control group (lubricating eye drop) and case group (latanoprost 50mcg/ml). We used OCT-A to evaluate peripapillary and macular vessel density parameters. Data were collected at baseline and at 1, 3, and 6 months following the use of eye drops. This study included a total of 32 eyes (16 cases and 16 controls) from 19 patients. After 6 months, the group using latanoprost IOP reduced IOP to 10.8 ± 0.64 versus 13.5 ± 0.54 mmHg in the control group (p < 0.001). We observed significant changes in OCT-A vessel density peripapillary parameters. The total radial peripapillary capillary (RPC) density (%) at month 6, in the eyes using latanoprost was 55.1 ± 1.05% and control was 57.9 ± 0.88%, p = 0.033. However, no changes were observed in macular vessel density parameters as well as retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) thickness between groups after 6 months of using latanoprost. No sight-threatening events were observed during follow-up in either group. Until now there is no evidence that just lowering IOP can benefit normotensive patients with ODD. In fact, we observed a significant decrease in RPC vessel density after 6 months of IOP reduction using latanoprost, compared to the control group.