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Purpose: To evaluate retinal blood flow changes in glaucomatous eyes after intraocular pressure (IOP) lowering and to determine whether a correlation exists between retinal capillary blood flow and IOP changes using optical coherence tomography angiography (OCTA) Materials and methods: OCTA images were obtained from glaucomatous eyes for the macula (n=24) and optic disc (n=21) in a prospective, cross-sectional observational study. Microvascular changes were analysed at two retinal layers: deep vascular plexus (DVP) and the superficial vascular plexus (SVP) as well as choriocapillaries (CC) were compared pre and six weeks post intraocular pressure (IOP) lowering treatment. Blood flow changes were analysed with ImageJ software and statistical analysis was performed via Stata with a p value of < 0.05 considered as statistically significant. Results: Retinal blood flow across the macula showed no statistical significance at: SVP (z-score = -0.887), DVP (z-score = -1.093) and CC (z-score = -1.423). Further, no statistically significant difference in blood flow was observed across the disc: SVP (z-score = -0.918), DVP (z-score = -1.057) and CC (z-score = -0.295). While IOP reduction was achieved (z-score = -5.049), visual acuity deteriorated (z-score= 1.686) Conclusion: No statistical difference was found in the data for all layers for both the areas surrounding the disc and macula at 6 weeks. OCTA can detect microstructural defects and future longitudinal studies may provide further insight into effects of IOP lowering treatment on retinal blood flow in glaucoma patients in longer term.

Evaluation of Retinal Blood Flow in Glaucoma Patients Pre and Post Treatment using OCT angiography