@article {Miguel667, author = {Ana Miguel and Andr{\'e} Silva and Joao Barbosa-Breda and Luis Azevedo and Abdulkarim Abdulrahman and Esther Hereth and Luis Abeg{\~a}o Pinto and Yves Lachkar and Ingeborg Stalmans}, title = {OCT-angiography detects longitudinal microvascular changes in glaucoma: a systematic review}, volume = {106}, number = {5}, pages = {667--675}, year = {2022}, doi = {10.1136/bjophthalmol-2020-318166}, publisher = {BMJ Publishing Group Ltd}, abstract = {Background/aims Optical coherence tomography angiography (OCTA) allows the study of vessel density (VD). We intended to perform a systematic review of studies focusing on longitudinal changes in peripapillary and macular VD measurements in glaucoma.Methods A search was performed across MEDLINE, Scopus, ISI Web of Science and Google Scholar, using the following query from inception until 20 September 2019: (({\textquotedblleft}optical coherence tomography angiography{\textquotedblright}[tiab]) OR (optical coherence tomography angiography[MeSH]) OR ({\textquotedblleft}OCTA{\textquotedblright}[tiab]) OR ({\textquotedblleft}OCT-A{\textquotedblright}[tiab]) OR ({\textquotedblleft}angio-OCT{\textquotedblright}[tiab]) OR ({\textquotedblleft}OCT- angiography{\textquotedblright}[tiab]) OR ({\textquotedblleft}OCT-angio{\textquotedblright}[tiab]) OR ({\textquotedblleft}OCT-angiographie{\textquotedblright}[tiab])) AND (glaucom*[tiab] OR glaucoma[MeSH]). Prospective studies that quantitatively assessed the longitudinal changes in VD in glaucoma with at least 3 months of follow-up were included.Results Ten out of 4516 studies were included. The rate of VD change in glaucoma varied from 0.036/year to 1.08/year and 1.3\% to 3.2\% per year, with significantly different rates between glaucoma and healthy controls. Five studies assessed VD change after glaucoma surgery, obtaining variable results, ranging from a temporary VD decrease to increase after 3 months. Meta-analysis was not possible due to a wide variation in methods, measurements and region of VD.Conclusion OCTA is a non-invasive technology, which shows promise in glaucoma. Measures should be taken to increase the quality and standardise the methodology of VD measures in OCTA longitudinal studies, for future meta-analyses.Data are available upon reasonable request. Available at request.}, issn = {0007-1161}, URL = {https://bjo.bmj.com/content/106/5/667}, eprint = {https://bjo.bmj.com/content/106/5/667.full.pdf}, journal = {British Journal of Ophthalmology} }