Comparison of the number of peripapillary perforating scleral vessels between glaucomatous eyes and healthy eyes

This study aimed to compare the number of peripapillary perforating scleral vessels (PPSVs) between eyes with and without glaucoma. A retrospective case-control analysis was performed on patients with glaucoma and control participants who underwent swept-source optical coherence tomography (SS-OCT) at a single institution. The number of PPSVs around the optic disc was counted on deep-learning assisted en face SS-OCT images created from 6 × 6 mm² peripapillary volumetric scans. The study included 33 eyes from 33 participants (21 eyes from 21 patients with glaucoma and 12 eyes from 12 healthy controls). The number of PPSVs was significantly lower in eyes with glaucoma (95% confidence interval [CI], 16.0-20.6) than in control eyes (95% CI, 24.2-29.0; P < 0.001). It was not associated with age in patients with glaucoma (P = 0.89). The receiver operating characteristic curve had an area under the curve of 0.95 (95% CI, 0.93-0.97); at a cutoff value of 21.50, the sensitivity and specificity for identifying glaucoma were 84.6%, and 91.7%, respectively. These outcomes suggest that the decrease in PPSVs in glaucoma may be related to perfusion loss in the retina or optic nerve, and the number of PPSVs may be a biomarker for detecting the risk of glaucoma.