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Medically reviewed by Dr. Kimberly Langdon Cull, M.D. on August 25, 2023

The retinal nerve fiber layer thickness and peripapillary vessel density were found to be decreased in the eyes of neuromyelitis optica spectrum disorder and primary glaucoma patients.  

Optic coherence tomography (OCT) is a non-invasive technique used for the visualization of microvasculature and large vessels in the eyes. The current study evaluated the microvasculature changes in terms of retinal nerve fiber layer (RNFL) thickness and vessel density (VD) in glaucomatous, neuromyelitis optica spectrum disorder (NMOSD), and normal control eyes, using OCT angiography (OCTA). The findings are published in the journal Photodiagnosis and Photodynamic Therapy

Baseline Characteristics

A total of 68 primary angle-closure glaucoma (PACG), 25 primary open-angle glaucoma (POAG), 51 NMOSD, and 37 healthy control participants were enrolled.

Peripapillary Vessel Density and Retinal Nerve Fiber Layer Thickness in PACG and POAG   Subjects

An increase in the severity of PACG was significantly related to a decrease in the superior hemifield and peripapillary VD. On the contrary, there was a significant association between increased PACG severity and reduced peripapillary RNFL thickness. An increase in the severity of POAG was significantly associated with decreased RNFL thickness and peripapillary VD.

Peripapillary VD and RNFL Thickness in NMOSD Subjects

In NMOSD patients with positive optic neuritis history, the RNFL thickness and peripapillary VD were significantly reduced compared to those in NMOSD patients without optic neuritis history. The generalized RNFL thinning and reduction of VD can distinguish between glaucomatous eyes and NMOSD with optic neuritis history.

CFD in Glaucoma Patients and Healthy Controls

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The choriocapillary flow density (CFD) was at a lower baseline in PACG-unaffected eyes compared to healthy controls and POAG-unaffected eyes. Similarly, CFD was significantly decreased in the PACG early eyes and PACG advanced eyes compared to POAG early eyes and POAG advanced eyes, respectively.

The density of peripapillary vessels and RNFL thickness were found to be decreased in NMOSD and glaucoma patients’ eyes when compared to healthy controls. Compared to POAG, PACG eyes demonstrated a decreased CFD.


Li, Y., Liu, W., Yan, Y., Wang, C., & Guo, H. (2023). Evaluation of microvascular changes in the retina and choriocapillaris in primary glaucoma and neuromyelitis optica spectrum disorder with optical coherence tomography angiography. Photodiagnosis and Photodynamic Therapy, 103699. https://doi.org/10.1016/j.pdpdt.2023.103699