Diurnal change of retinal vessel density related to hemodynamic variation in treatment-naïve low-teens normal-tension glaucoma

Abstract This study undertook to investigate the diurnal variation of optical coherence tomography angiography (OCTA) -derived retinal vessel density (RVD) in glaucoma patients with low baseline intraocular pressure (IOP). A prospective evaluation was performed on low-teens normal-tension glaucoma (low-teens NTG) patients with pre-treatment IOP < 15 mmHg and 32 healthy subjects. Superficial peripapillary and macular RVD by OCTA, IOP, and systemic blood pressure (BP) were all measured four times per day (from 9:00 a.m. to 6:00 p.m.). In the low-teens NTG group, the magnitude of diurnal changes in peripapillary RVD and macular RVD were greater than those in the healthy group. Diurnal variations of diastolic BP (DBP) and mean ocular perfusion pressure (MOPP) also were greater in the low-teens NTG group. As for the patterns of diurnal RVD change, the inferior and temporal sections of macular RVD showed significant differences between the two groups. Diurnal changes of RVD and MOPP and were greater than those in healthy eyes. The macular RVD and MOPP showed different diurnal patterns between the two groups. From these findings, OCTA-derived RVD variation could be related to hemodynamic variability in low-teens NTG