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Changes in circumpapillary retinal vessel density after acute primary angle closure episode via OCT angiography



To investigate the changes and evaluate the diagnosis value of circumpapillary vessel density (VD) in cases of acute primary angle closure (APAC).


Case–control study.


APAC patients with a history of unilateral acute attack were enrolled. The eyes with acute episode constituted the case group while the contralateral eyes without attack consisted of the control group. Ophthalmic examinations including slit-lamp examination, best-corrected visual acuity, intraocular pressure and visual field were carried out. Retinal nerve fiber layer (RNFL), macular ganglion cell complex (GCC) were measured by spectral-domain optical coherence tomography, while VD was assessed by optical coherence tomography angiography.


The whole en face image vessel density (wiVD), circumpapillary vessel density (cpVD) and inside disk VD for both all vessels and capillary were all significantly lower in the APAC eyes compared to the fellow eyes (P < 0.01 for all). In APAC eyes, the wiVD, inside disk VD and cpVD both for all vessels and capillary were all positively correlated with RNFL and GCC thicknesses but negatively correlated with the mean deviation (MD), pattern standard deviation (PSD) and the duration of acute attack (all P < 0.01). From the ROC curve, the cpVDcap, wiVDcap, cpVDall and wiVDall all showed comparable diagnostic ability with RNFL, GCC and MD to differentiate eyes with APAC from the fellow eyes (all P > 0.05). The inside disk VDcap and VDall demonstrated significant lower diagnostic ability than the cpVDcap, wiVDcap, cpVDall and wiVDall (all P < 0.001).


In APAC eyes, circumpapillary VD decreased significantly compared with the fellow unaffected eyes. They were significantly correlated with thicknesses of RNFL and GCC, and visual field MD and PSD in the APAC eyes. The patients with longer duration of acute attack were more likely to have lower cpVD. For APAC, the diagnostic ability of wiVD and cpVD was similar with RNFL, GCC and MD and was higher than inside disk VD.

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Fig. 1

Data availability

The data used to support the findings of this study are included within the article.


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This study was supported by the Wenzhou Municipal Science and Technology Bureau of China (Grant No. Y20190170) and Research Initiation Project of the Affiliated Eye Hospital of Wenzhou Medical University (KYQD202001).

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All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by [LN and PL], [YY, WP] and [JX, YKC, TL]. The first draft of the manuscript was written by [LN and LF] and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Peirong Lu.

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All procedures performed in studies involving human participants were in accordance with the Clinical Research Ethics Committee of the Affiliated Eye Hospital of Wenzhou Medical University, and followed the tenets of the Declaration of Helsinki in 1964.

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Informed consent was obtained from all individual participants included in the study. Patients signed informed consent regarding publishing their data and photographs.

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Nie, L., Xu, J., Fu, L. et al. Changes in circumpapillary retinal vessel density after acute primary angle closure episode via OCT angiography. Int Ophthalmol 41, 2389–2397 (2021).

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