Primary open angle glaucoma (POAG) is an irreversible progressive optic neuropathy, leading to progressive visual field loss. Its diagnosis is based on the appearance of the optic disc, the thickness of the peripapillary retinal nerve fiber layer (RNFL), the internal ganglion complex (IGC), and by standard achromatic perimetry. However, individuals with increased axial length often have discs with special characteristics that make glaucomatous changes not easily interpretable.
Recent advances in optical coherence tomography angiography (OCTA) technology have allowed the study of an alternative image for the diagnosis of POAG, taking into account peripapillary vascular density (PVD). This new finding could help in the diagnosis of POAG, especially in the myopia population, as it presents the anatomical and morphological changes described.
We reported a series of 4 cases for the analysis and comparison of Optical Coherence Tomography (OCT) and OCTA of a healthy emmetropic patient, a healthy myopic patient and two myopic patients diagnosed with POAG. Analyzing the cases, a decrease in PVD can be observed in eyes with glaucoma, without this value being altered by myopia or axial length. This could provide information for the early diagnosis of POAG, especially in complex cases of myopic eyes. Future research in the medium and long term with myopic patients is required to determine the diagnostic power of PVD measured by OCTA and to determine if it has greater diagnostic power than RNFL and IGC.