Background/aims To examine longitudinal optical coherence tomography angiography (OCTA) changes in macula and optic nerve head (ONH) in healthy, glaucoma suspect (GS) and primary open-angle glaucoma (POAG) eyes. Methods Healthy, GS and POAG eyes from Diagnostic Innovations in Glaucoma Study with ≥2 years follow-up and four visits of macular/ONH OCTA imaging were included. Rates of macular wiVD (whole-image vessel density) and ONH wiCD (whole-image capillary density) changes were calculated for each diagnosis group using join mixed-effect modelling. Differences in wiVD/wiCD change rates across diagnoses were examined through pairwise comparison. Relationships of baseline 24-2 visual field (VF) mean deviation (MD) with wiVD/wiCD change rates were evaluated for POAG eyes. Results There were 36, 57 and 79 eyes (25, 38 and 50 subjects) in healthy, GS and POAG groups, respectively. Rates of wiVD (range:−0.72 to −0.92 %/year) and wiCD (range:−0.28 to −0.66 %/year) loss were different from zero in all groups (p<0.05). The rates of wiCD loss differed across all diagnosis groups (p<0.001), while wiVD change rates did not increase when comparing healthy to GS eyes (p=0.167). Baseline VF MD showed a significant but modest correlation with the rates of both wiVD and wiCD loss (p<0.05), and the correlation with wiCD change rate was slightly stronger (R2=0.27 vs 0.16). Conclusions In glaucoma, there is earlier microvasculature loss in the ONH than in the macula. Moreover, ONH VD loss shows a slightly stronger association with baseline VF than macular VD. Observing ONH VD loss with OCTA may help to monitor early glaucoma, which should be confirmed by future larger studies. The datasets generated and/or analysed during the current study are available from the corresponding author on reasonable request. Data are available on reasonable request.

中文翻译：

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健康、青光眼疑似和已建立的青光眼眼的黄斑和视神经头纵向 OCTA 血管密度丢失


背景/目标 检查健康、青光眼疑似 （GS） 和原发性开角型青光眼 （POAG） 眼睛的黄斑和视神经头 （ONH） 的纵向光学相干断层扫描血管造影 （OCTA） 变化。方法 包括来自青光眼诊断创新研究的健康、GS 和 POAG 眼，随访 ≥ 2 年，并进行了 4 次黄斑/ONH OCTA 成像就诊。使用联合混合效应模型计算每个诊断组的黄斑 wiVD （全图像血管密度） 和 ONH wiCD （全图像毛细血管密度） 变化率。通过成对比较检查不同诊断之间 wiVD/wiCD 变化率的差异。评估 POAG 眼基线 24-2 视野 （VF） 平均偏差 （MD） 与 wiVD/wiCD 变化率的关系。结果 健康组、GS 组和 POAG 组分别有 36 、 57 和 79 只眼 （25 、 38 和 50 例受试者）。所有组的 wiVD （范围：-0.72 至 -0.92 %/年） 和 wiCD （范围：-0.28 至 -0.66 %/年） 的丢失率均不为零 （p<0.05）。所有诊断组的 wiCD 丢失率都不同 （p<0.001），而与健康眼与 GS 眼相比，wiVD 变化率没有增加 （p=0.167）。基线 VF MD 与 wiVD 和 wiCD 丢失率 （p<0.05） 呈显著但适度的相关性，与 wiCD 变化率的相关性略强 （R2=0.27 vs 0.16）。结论 在青光眼中，ONH 的微血管系统丢失早于黄斑。此外，ONH VD 丢失与基线 VF 的相关性略强于黄斑 VD。使用 OCTA 观察 ONH VD 丢失可能有助于监测早期青光眼，这应该通过未来更大规模的研究来证实。 在当前研究期间生成和/或分析的数据集可应合理要求从通讯作者处获得。数据可应合理要求提供。