Changes in Macular Perfusion afterTrabeculotomy Operation in Primary Open Angle Glaucoma by Optical Coherence Tomography Angiography

: Purpose: The aim of study is to evaluate changes in macular vessel density after trabeculotomy operation and reduction of intra ocular pressure (IOP) in primary open angle glaucoma (POAG) by optical coherence tomography angiography (OCTA). Methods: The study included 28 eyes presented by POAG who were treated at an Ophthalmic Center in Egypt between February 2018, till august 2019. All studied eyes underwent visco-trabeculotomy operation. Macular vessel density (VD) was evaluated by OCTA pre-operative and then for 3 months postoperative. Results: The mean age of the study patients was 55.96 ± 10.43 years. They included 23 males (82.1%) and 5 females (17.9%). The mean preoperative IOP was 26.55 ± 7.279. At 3 months follow up the mean IOP was 13.20 ± 4.69 with P ˂ 0.001. There was a significant improvement in mean foveal VD from 15.04 ± 4.23 preoperatively to 18.47 ± 4.71 at 3 months postoperatively with p ˂ 0.001. The mean superior macular zone also showed significant improvement from 45.55 ± 4.54 preoperatively to 48.84 ± 5.80 at 3 months with p=0.027. Mean inferior macular VD showed improvement from 46.69 ± 5.62to 49.95 ± 7.10 three months post operatively with P=0.031. There was no significant change in nasal macular density, while in temporal macular vessel density there was early reduction in the mean VD from 45.01 ± 3.79 to 43.27 ± 3.97 two weeks postoperatively. However, it returned to near preoperative value in the next follow ups to 45.04 ± 5.19 at three months. Conclusions: The current study showed changes in macular vessel density after trabeculotomy operation in patients with primary open angle glaucoma correlated with IOP reduction. However, it has yet to be evaluated whether these changes have a significant clinical significance in long-term follow-up.