Purpose: We evaluate the ability of optical coherence tomography angiography parameters, such as the peripapillary vessel density of the superficial retina and prelaminar flow index of the optic disc (PLFI), to differentiate primary open-angle glaucoma (POAG) and ocular hypertension (OH) from normal eyes. Methods: The vessel density, PLFI, mean deviation of the visual field, circumpapillary retinal nerve fiber layer thickness (cpNFLT), and global loss volume of the ganglion cell complex were evaluated in one eye of 105 subjects with POAG and OH and normal eyes. The discriminatory powers of these parameters were evaluated based on the area under the curve (AUC) of the receiver operation characteristic curve and multiple comparisons. Results: The vessel density (P < 0.001) and PLFI/unit area (PLFI/UA; P = 0.020) in eyes with POAG were significantly less than in normal eyes. The vessel density in eyes with OH was significantly (P = 0.018) reduced, whereas the PLFI/UA, global loss volume and cpNFLT were unaffected. The AUCs of the vessel density to discriminate glaucoma and OH from normal eyes were 0.832 and 0.724, respectively, and were significantly better than the PLFI/UA, in which the AUCs were 0.662 (P = 0.002) and 0.569 (P = 0.038), respectively. The powers of the vessel density and PLFI/UA to discriminate POAG from normal eyes were inferior to the global loss volume (P = 0.006 and <0.0001) and cpNFLT (P = 0.055 and P < 0.0001, respectively). Conclusions: The vessel density and PLFI/UA decreased significantly in glaucomatous eyes. The vessel density was more efficient than the PLFI/UA for differentiating glaucoma and OH from normal eyes.

Aims: To evaluate the statistical significance of the parameters that affect underestimation of intraocular pressure (IOP) after laser in situ keratomileusis (LASIK) for myopia. Methods: In this prospective case series study, patient age, axial length, preoperative corneal curvature, preoperative central corneal thickness (CCT), preoperative IOP, and ablation depth were studied to determine whether they affect the underestimation of IOP in the right eyes of 100 consecutive patients who underwent LASIK. Results: The preoperative IOP was the most important parameter for an amount of underestimated Goldmann applanation tonometric IOP (GAT) and non-contact tonometric IOP (ncIOP) at 1 month (r = 0.654, p<0.0001, R² = 0.427, and r = 0.694, p<0.0001, R² = 0.481, respectively) and 3 months (r = 0.637, p<0.0001, R² = 0.406, and r = 0.726, p4.000). However, these parameters had small bivariate correlation coefficients, and were considered as minor parameters. Conclusion: Preoperative IOP is the most important parameter that affects an underestimation of IOP after LASIK for myopia. Eyes with a higher true IOP have a larger underestimation of the IOP after LASIK for myopia. From these results, the importance of the modulus of elasticity on IOP measurements was discussed.

Purpose To assess the responses of the superficial peripapillary retinal vessel density (VD) and prelaminar flow index (PLFI) to topical Rho-assisted coiled-coil forming protein kinase (ROCK) inhibitor ripasudil and alpha-2 agonist brimonidine using optical coherence tomography angiography. Methods This is a prospective, non-randomized, comparative cohort study. We studied the response of optical coherence tomography angiography (OCTA) parameters to drugs in 24 eyes treated with ripasudil and 23 eyes treated with brimonidine at the Sensho-kai Eye Institute. After division by the signal strength (SS), we compared the responses of peripapillary VD/SS and PLFI/unit area (UA)/SS to topical eye drops in eyes with primary open-angle glaucoma (POAG) and ocular hypertension (OH). Results In the superficial peripapillary retina, VD/SS increased significantly in the ripasudil-treated eyes (12.5 ± 21.7%, P = 0.018), but not in the brimonidine-treated eyes (− 2.0 ± 13.8%, P = 0.484). In the deeper area of the optic disc, the changes in the PLFI/UA/SS in the brimonidine-treated eyes (+ 0.9 ± 8.9%, P = 1.00) and ripasudil-treated eyes (− 1.3 ± 8.5%, P = 0.241) were not significant. Multivariate discriminant analysis showed that the change in the peripapillary VD/SS was the most important parameter (P = 0.0186) for differentiating ripasudil- and brimonidine-treated eyes. Conclusions The topical ROCK inhibitor ripasudil enhanced the peripapillary VD in POAG and OH, whereas the alpha-2 agonist brimonidine did not. The PLFI did not respond to either drug.

To investigate the effects of topical instillation of 0.5% tranilast eye drops on intraocular pressure (IOP) and bleb formation after glaucoma filtering surgery. This was a prospective, randomized, double-masked, and controlled clinical trial. A total of 52 eyes of 52 patients were randomly assigned to receive either 0.5% tranilast eye drops (24 eyes) or vehicle saline solution (28 eyes) 4 times daily for 3 months after trabeculectomy. Features of the bleb, such as vascularization and size, and intraocular pressure were studied. The incidence of vascularized bleb and “pseudopod” formation 6 months post treatment were more common in tranilast-treated eyes than control eyes (P = 0.019 and P = 0.043, respectively). The bleb was significantly larger at 6 and 12 months (P = 0.024 and P = 0.049, respectively), and reduction of the IOP was more significant for 2 years postoperatively (P = 0.002 to P = 0.032) in tranilast-treated eyes than control eyes. No vision-threatening side reactions were associated with tranilast. The use of topical tranilast after filtering surgery alleviates ischemia of the filtering bleb, reduces IOP, and increases the size of the bleb.