APSified Peripapillary Vessel Density in Glaucoma Suspects and Open-Angle Glaucoma

<b>Background/Objectives</b>: Optical coherence tomography-angiography (OCT-A) is a non-invasive method of visualizing the capillary system. As vascular dysregulation impacts glaucoma pathogenesis, the aim of this study was to evaluate APSified-BMO-based-peripapillary vessel density (VD) in patients with ocular hypertension (OHT), pre-perimetric-open-angle glaucoma, as well as primary (POAG) and secondary (SOAG) open-angle glaucoma in comparison to healthy controls using OCT-A. <b>Methods</b>: The present study included 180 eyes from 115 patients of the Erlangen Glaucoma Registry, divided into 35 eyes with OHT, 16 pre-perimetric-OAG eyes, 64 OAG eyes-which were subdivided into 37 POAG and 27 SOAG eyes-and 65 healthy controls. All subjects underwent measurements of the retinal nerve fiber layer (RNFL), inner nuclear layer (INL), retinal ganglion cell (RGC) layer, and Bruch membrane opening-minimum rim width (BMO-MRW). APSified-BMO-based-peripapillary vessel density (VD) was visualized by using OCT-A and quantified using the Erlangen Angio Tool. <b>Results</b>: Mean APSified-BMO-based peripapillary VD showed a significant correlation with age (<i>p</i> < 0.0001). Considering the age effect, mean APSified-BMO-based peripapillary VD of OAG was significantly lower compared to healthy eyes (<i>p</i> < 0.0001) and OHT (<i>p</i> = 0.016). Subgroup analysis yielded a significant difference in mean APSified-BMO-based peripapillary VD between controls and POAG (<i>p</i> = 0.001) and SOAG (<i>p</i> = 0.018), respectively. In addition, a significant difference was observed between OHT and POAG patients (<i>p</i> = 0.036). No significant differences were observed between the OHT, pre-perimetric-OAG, and healthy eyes, respectively. <b>Conclusions</b>: As peripapillary VD was significantly decreased in glaucoma patients compared to controls, the data might suggest that peripapillary VD might be useful for monitoring glaucoma progress.