Abstract
BackgroundPrimary open-angle glaucoma (POAG) is a progressive neurodegenerative disease which leads to irreversible blindness. An elevated intraocular pressure (IOP) is considered to be the main risk factor for the disease progression. It is known that retinal blood flow is altered in POAG eyes. Tafluprost, a prostaglandin analogue which lowers the IOP, has shown to also improve the retinal blood flow in animals.MethodsThe current study therefore evaluated the retinal vessel density in the peripapillary and macular region of POAG patients with normal IOP treated with topical Tafluprost (n = 20) compared to surgically treated patients with normal IOP (n = 22) using optical coherence tomography angiography (OCT-A). The retinal flow density was obtained after binarisation and evaluated in five sectors.ResultsThere was a significantly higher peripapillary flow density in all sectors in Tafluprost treated eyes when compared to post-surgery eyes. The flow density in the inferior sector of the superficial plexus in the macular region was also significantly higher in the Tafluprost group.Conclusions: These results indicate that Tafluprost not only lowers IOP, but may also enhance retinal blood flow in POAG patients with a normal IOP.
Highlights
Primary open-angle glaucoma (POAG) is a progressive neurodegenerative disease which leads to irreversible blindness
The present study found a significantly higher retinal flow density in all five sectors of the optic nerve head (ONH) area and in the inferior sector of the superficial retinal plexus in the macular region within Tafluprost-treated POAG eyes compared to non-treated post-surgery POAG eyes
Our study aimed to investigate the potential effect of Tafluprost on flow density in POAG patients using optical coherence tomography angiography (OCT-A) examination of both the optic nerve head and the macular region in a cross-sectional approach
Summary
Primary open-angle glaucoma (POAG) is a progressive neurodegenerative disease which leads to irreversible blindness. Patients present a slow, progressive deterioration of nerve fibre layer and increasing visual field losses. An elevated IOP is the most crucial risk factor for POAG as well as disease progression [1]; current treatment options focus on lowering it. The regulation of IOP in POAG does not ensure the stabilization of this irreversible disease and deterioration in the patient’s visual field remains possible. In addition to the mechanical pathophysiological theory of elevated IOP, retinal blood flow is reduced in glaucoma [3]. Vascular dysregulation and the Weindler et al BMC Ophthalmology (2020) 20:444 resulting insufficient blood supply may lead to a progressive loss of nerve fibres
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