Purpose To compare the rates of peripapillary vessel density (pVD) loss and retinal nerve fibre layer (RNFL) thinning in normal tension glaucoma (NTG) and primary angle closure glaucoma (PACG).
Methods Baseline age and severity-matched NTG and PACG eyes (75 eyes of 60 patients for each subtype) were observed longitudinally. All participants’ RNFL thickness were measured by optical coherence tomography (OCT); pVD were measured by swept-source OCT-angiography (OCT-A) and quantified by a customised MATLAB program. The rate of pVD loss and RNFL thinning were estimated by linear mixed-effects models.
Results NTG eyes had significant pVD loss in all sectors (p≤0.05) while PACG eyes’ pVD loss was borderline significant in the global region (p=0.05). Significant RNFL thinning was detected in the inferotemporal and superonasal regions of both groups, and the superotemporal region in the NTG group (all p≤0.02). NTG had faster rate of pVD loss in the global (difference (95% CI) −1.08 (−1.90 to –0.27) %/year), temporal (−1.57 (−2.91 to –0.23) %/year) and superotemporal (−1.46 (−2.65 to –0.26) %/year) regions than PACG (all p≤0.02), without significant difference of the rate of RNFL thinning. A lower baseline mean deviation (MD) was associated with a faster rate of global pVD loss, while a lower baseline pVD was associated with a slower rate of global pVD loss in multivariable analyses (both p≤0.04).
Conclusions NTG had more extensive and faster rate of pVD loss than PACG. Baseline global pVD and MD were independently associated with the rate of pVD loss in NTG.
- intraocular pressure
Data availability statement
All data relevant to the study are included in the article or uploaded as supplementary information.
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PPC and RS are joint first authors.
PPC and CCT contributed equally.
Contributors PPC contributed to study design, conceptualisation, data collection, data interpretation, writing up of manuscript, revision of manuscript and responses to reviewers’ comments. RS contributed to conceptualisation, data curation, data analysis, drafting of manuscript and responses to reviewers’ comment. CC reviewed, edited and supervised the OCT and OCT-A analysis. MY reviewed and supported the statistical analysis. C-PP reviewed and edited the manuscript. CCT is the funding holder and the guarantor of this manuscript. CCT supervised and reviewed the manuscript.
Funding This study was supported in part by the Endowment Fund for Lam Kin Chung, Jet King-Shing Ho Glaucoma Treatment and Research Centre, Hong Kong.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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