Optical coherence tomography angiography compared with optical coherence tomography for detection of glaucoma progression with high myopia

Little is known about the change of macular and peripapillary vessel density comparing to macular ganglion cell-inner plexiform layer (mGCIPL) thickness or peripapillary retinal nerve fiber layer (pRNFL) thickness in high myopic glaucoma in the longitudinal follow-up. A total of 62 glaucoma patients with high myopia (71 eyes) were analyzed over an average follow-up of 2.88 years, with at least four optical coherence tomography angiography (OCTA) imaging sessions. Among the participants, 47 eyes exhibited stable visual fields, while 24 eyes showed progression. We compared the longitudinal changes between the macular/peripapillary vessel density (VD) and the mGCIPL/pRNFL thickness in the two groups. Our results indicated a significantly greater decline in the macular and peripapillary VD in the progressive group compared to the stable group. (all p < 0.05) However, there were no significant differences in the rate of changes of mGCIPL thickness or the pRNFL thickness between the two groups. Overall, this study demonstrates that VD decreases are detectable over time in the highly myopic glaucoma patients. OCTA could be considered in the imaging algorithm in the follow up of glaucoma progression in the highly myopic patients.