To investigate the peripapillary vascular metrics in early normal tension glaucoma (NTG) and early primary angle closure glaucoma (PACG) eyes using optical coherence tomography angiography (OCT-A). One or both eyes of each subject were imaged for a 3 × 3 mm peripapillary region by swept-source OCT-A (DRI-OCT Triton, Topcon, Japan) and assessed by an automated MATLAB program. OCT-A metrics including circumpapillary vessel density (cpVD) and fractal dimension (cpFD) were compared. Their association with visual field (VF) parameters and retinal nerve fiber layer (RNFL) thickness were determined. Sixty-eight eyes of 51 PACG, 68 eyes of 48 NTG, and 68 eyes of 49 control subjects were cross-sectionally analyzed. NTG eyes had significantly lower global cpVD (52.369 ± 0.781%) compared with PACG eyes (55.389 ± 0.721%, P = 0.004) that had comparable disease severity and average RNFL thickness. Multivariable analysis revealed that, for PACG and NTG eyes, decreased cpVD ([PACG] β = −4.242; CI: −8.120, −0.363 vs [NTG] β = −5.531; CI: −9.472, −1.590) and cpFD ([PACG] β = −8.894;CI: −11.925, −5.864 vs [NTG] β = −12.064; CI: −17.095, −6.932) were associated with decreased RNFL thickness (all P ≤ 0.032); with a stronger association between decrease cpFD and decreased RNFL thickness in NTG eyes (P = 0.028). Decreased cpVD was associated with decrease mean deviation (MD) in NTG eyes (β = −0.707; CI: −1.090, −0.324; P ≤ 0.001) and not associated with the visual field parameters in PACG eyes. Early NTG had lower global cpVD compared with early PACG, despite similar disease severity and average RNFL thickness.

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Purpose The purpose of this study was to determine the prevalence of myopia among patients with primary angle closure disease (PACD) in rural China and their ocular biometric characteristics. Methods Study subjects were recruited from the Handan Eye Study. A/B-mode scan (Cine Scan, Quantel Medical, Cedex, France) was used to measure the axial length, anterior chamber depth (ACD), and lens thickness (LT). PACD was defined as the anterior chamber angle being considered closed when 180 degrees or more of the posterior pigmented trabecular meshwork were not visible on the gonioscopy. Myopia was defined as a spherical equivalent (SE) refractive error ≤−0.5 diopter (D). Persons who did not meet PACD definition were classified as the open-angle (OA) group. Results The overall prevalence of myopia in persons with PACD was 13.7% (11.6% in primary angle closure suspect [PACS], 21.6% in primary angle closure [PAC], 62.5% in primary angle closure glaucoma [PACG]). The age-specific prevalence of myopia in PACD eyes was 41.7% at 30 to 39 years old, 12.3% at 40 to 49 years old, 8.7% at 50 to 59 years old, 10.7% at 60 to 69 years old, and 31.7% at age 70 years and over. PACD had shorter AL (22.2 ± 0.8 vs. 22.9 ± 0.9 mm, P < 0.001), shallower ACD (2.3 ± 0.3 vs. 2.8 ± 0.4 mm, P < 0.001), and greater LT (5.0 ± 0.5 vs. 4.7 ± 0.5 mm, P < 0.001). PACD had even thicker lenses and deeper ACD with age than those with OA (all P ≤ 0.025) from 30 years to 70 years of age and over. Conclusions Myopia was common among persons with PACD who were less than 40 years of age in this rural Chinese population, and over half of those with PACG were myopic.

Purpose To prospectively determine the relationship between optical coherence tomography angiography (OCTA) metrics and visual field (VF) progression in eyes with normal tension glaucoma (NTG). Methods Prospective, cohort study conducted from January 2017 to October 2021. OCTA metrics at the peripapillary region (circumpapillary vessel density (cpVD), vessel diameter index (VDI) and fractal dimension (FD) in the radial superficial capillary network), and the macular region (macular vessel density, foveal avascular zone (FAZ) area, FAZ circularity and macular FD in superficial capillary plexus (SCP) and deep capillary plexus (DCP)), were investigated and measured by a customized MATLAB program. VF was evaluated semiannually using standard automated perimetry. Cox proportional hazards model was used to evaluate the relationship of OCTA metrics at baseline to the risk of NTG progression over time. Results The cohort included 164 NTG patients (270 eyes), which were followed up for at least 2 years. Over a mean follow‐up period of 48.58 ± 7.98 months, 42 of the 270 NTG eyes (15.56%) developed VF deterioration. Among OCTA metrics at peripapillary region, lower superotemporal cpVD (HR per SD decrease, 1.401; 95% CI, 1.017–1.929) was associated with VF deterioration after adjusting for reported risk factors at baseline. Conclusions Lower superotemporal cpVD at peripapillary region measured from OCTA improves the prediction of VF deterioration in NTG. These findings provided further evidence to support the prognostic role of OCTA in the risk assessment of NTG progression.