Alterations in Retinal Vasculometry After Acute Primary Angle Closure Episode: A Comparative Analysis.

Area of Science:

• Ophthalmology
• Medical Imaging
• Vascular Biology

Background:

• Acute primary angle closure (APAC) is a critical ophthalmic condition.
• Understanding the long-term ocular effects of APAC is crucial for patient management.
• Retinal vasculometry offers insights into ocular health and disease progression.

Purpose of the Study:

• To investigate alterations in retinal vasculometry in eyes successfully treated for APAC compared to unaffected fellow eyes.
• To identify specific retinal vascular parameters affected by APAC.
• To explore the relationship between these alterations and factors like intraocular pressure (IOP).

Main Methods:

• A cross-sectional study involving 116 patients with unilateral APAC.
• Retinal photographs were analyzed using deep learning software within two weeks of IOP control.
• Evaluation of retinal vascular parameters including caliber, density, complexity, tortuosity, and branching angles.

Main Results:

• APAC eyes exhibited significantly larger retinal vein caliber, increased length-to-diameter ratios in arteries and veins, and lower arteriovenous ratio (AVRQ4) compared to fellow eyes.
• Reduced bifurcation densities, fractal dimension (FD), and branching angles were observed in APAC eyes.
• Higher IOP, lower AVRQ4, and decreased arterial FD were independently associated with APAC.

Conclusions:

• Significant retinal vasculometry alterations persist in APAC eyes despite successful IOP control.
• These vascular changes may play a role in the development of glaucomatous optic neuropathy.
• Further longitudinal studies are warranted to confirm the contribution of these alterations to disease progression.