Progressive vessel density reduction on optical coherence tomography angiography in glaucoma eyes with disc hemorrhages.

ABSTRACT: Purpose To identify longitudinal changes in peripapillary and parafoveal vessel density (VD) measured by optical coherence tomography (OCT) angiography in primary open-angle glaucoma (POAG) eyes with disc hemorrhages (DH). Design Prospective, cohort study conducted from August 2016 to August 2020 Participants 18 eyes of 18 Asian-Indian participants with POAG who presented to the clinic with a single DH in the peripapillary region were consecutively recruited. Methods The study was conducted at a tertiary eye care center. All participants who were recruited underwent a baseline OCT and OCT Angiography (OCTA) which were repeated every 4-6 months. Main outcome measures Peripapillary VD and retinal nerve fiber layer (RNFL) thickness, and parafoveal VD and ganglion cell-inner plexiform layer (GCIPL) thickness in the DH sector and the corresponding mirror-image sector across the horizontal meridian (control) were evaluated over time using linear mixed effects models. Results The baseline average RNFL thickness was 79 ± 9μm. Mean duration of follow-up was 2.6 ± 0.7 years. In the DH sector, all VD and structural parameters showed a significant negative slope (p 0.05) but the rate of change of the peripapillary and parafoveal VDs were significant (p Conclusions POAG eyes with a DH showed, not only progressive RNFL and GCIPL loss in the DH sector, but also progressive peripapillary and parafoveal VD reduction in the DH and non-DH regions as documented on OCTA.