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Document Type

Original Article

Abstract

Background: Primary open angle glaucoma (POAG) is defined as a chronic optic neuropathy, which is represented by characteristic defect of retinal nerve fiber layer and corresponding loss of visual field due to retinal ganglion cells degeneration. Aim of the work: assessment of changes of peri-papillary microvasculature in glaucomatous patients after surgical reduction of IOP using optical coherence tomography angiography (OCTA). Patients and Methods: Study was carried out on 20 eyes of 16 POAG patients who underwent subscleral trabeculectomy. Vessel density within the peri-papillary region, nasal, and temporal sectors were measured prior to the operation, one week, one month, and three months later using OCTA. Results: Intraocular pressure (IOP) was reduced from preoperative baseline value (30.35±5.05 mmHg) to (12.70±1.49 mmHg) at 3 months postoperatively, (P< 0.001). Superficial vascular complex vessel density (SVC VD) within per-ipapillary region, nasal and temporal sector were significantly increased postoperative 1 month and 3 months as compared to preoperative value, (P< 0.001). While insignificant difference between the mean value of preoperative Deep vascular complex vessel density (DVC VD) within peri-papillary region, nasal and temporal sector comparing to postoperative 1 week, 1 month and 3 months, (P> 0.05). The degree of SVC VD improvement was significantly related to greater IOP reduction. Conclusion: Surgical reduction of IOP can improve the perfusion in superficial retinal layer and stabilize the perfusion in deep retinal layer. The degree of ocular perfusion improvement was significantly related to greater IOP reduction.

Keywords

Glaucoma surgery; Peripapillary vessel density; OCT angiography

Subject Area

Ophthalmology

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