Abstract
Purpose :
Primary open-angle glaucoma (POAG) is a progressive neurodegenerative disease which leads to irreversible blindness. An elevated intraocular pressure (IOP) is considered to be the main risk factor for the disease progression. It is known that retinal blood flow is altered in POAG eyes. Tafluprost, a prostaglandin analogue which lowers the IOP, has shown to also improve the retinal blood flow in animals.
Methods :
The current study therefore evaluated the retinal vessel density in the peripapillary and macular region of POAG patients with normal IOP treated with topical Tafluprost (n=20) compared to surgically treated patients (including deep sclerectomy, trabeculotomy and trabeculectomy) with normal IOP (n=22) using optical coherence tomography angiography (OCT-A Topcon DRI OCT Triton Tokyo, Japan). The OCT-A was performed in the superficial peripapillary Plexus as well as the superficial and deep perimacular Plexus. The retinal flow density was obtained after binarisation using Matlab® and evaluated in five sectors (superior, inferior, nasal, temporal, central). The statistic analysis was performed using the parametric t-test with Sidàk correction.
Results :
There was a significantly higher peripapillary flow density in all sectors in Tafluprost treated eyes when compared to post-surgery eyes (central 39.3 ± 11.8% versus 32.8 ± 5.9%, p=0.04; superior 41.1 ± 9.4% versus 32.1 ± 7.4%, p = 0.001; temporal 32.1 ± 14.9% vs 20.9 ± 5.9%, p < 0.0001; inferior 42.6 ± 12.4% versus 30.4 ± 8.9%, p < 0.0001; nasal 23.8 ± 10.1% versus 15.7 ± 4.9%, p = 0.03). The flow density in the inferior sector of the superficial plexus in the macular region was also significantly higher in the Tafluprost group 26.6 ± 10.5% versus 19.7 ± 3.2%, p = 0.03).
Conclusions :
These results suggest that there is a significantly higher flow density with patients with POAG under Tafluprost therapy when compared to surgically treated POAG patients. This may indicate that IOP lowering surgeries should be performed rather late.
This is a 2021 ARVO Annual Meeting abstract.