Optical Coherence Tomography Angiography based on Effects of Intra Ocular Pressure on Retinal Blood Flow in POAG

Background: Globally, glaucoma accounts for a disproportionate share of both permanent blindness and disability and morbidity. Present glaucoma treatments aim to delay the disease's progression by lowering intraocular pressure (IOP). Aim: Patients with primary open-angle glaucoma will undergo optical coherence tomography angiography (OCTA) to assess the ocular microvasculature's response to trabeculectomy and anti-glaucoma medication for the purpose of reducing intraocular pressure (IOP). Subjects and methods: From November 2022 through November 2023, forty eyes participated in this prospective clinical experiment. Two groups of patients were analyzed. One group was given medicine to reduce glaucoma, and another group had trabeculectomy done. Results: The degree to which changes in retinal vascular density occur in response to intraocular pressure (IOP) lowering differs between treatment modalities. While the medically treated group showed only modest changes, the trabeculectomy group demonstrated a statistically significant improvement in peripapillary and retinal vascular density. Microvascular alterations in the peripapillary and macular areas, both at baseline and 6 months after treatment, were not significantly different in the medical treatment group. Conclusion: Retinal vascular alterations in POAG are associated with a decrease in intraocular pressure, as this investigation confirms. Although intraocular pressure (IOP) can be successfully reduced with either medicinal or surgical methods, trabeculectomy seems to improve ocular microcirculation more noticeably. One of the possible benefits of OCTA is its ability to observe vascular changes without intrusive procedures. This could be useful for disease monitoring and treatment optimization.