Background: Retinal vascular abnormalities may be associated with glaucomatous damage. Adaptive optics (AO) is a new technology that enables analysis of retinal vasculature at the cellular level in vivo. The purpose of this study is to evaluate retinal arteriolar parameters using the adaptive optics fundus camera (AO -FC) rtx1 in patients with primary open-angle glaucoma (POAG) at different stages and to investigate the relationship between these parameters and changes in optical coherence tomography (OCT) and perimetry. We wanted to assess whether vascular changes could be a cause or effect of glaucomatous damage.
Methods: Parameters of retinal supratemporal and infratemporal arterioles (wall thickness (WT), lumen diameter (LD), total diameter (TD), wall-to-lumen ratio (WLR), and cross-sectional area of the vascular wall (WCSA)) were analysed with the rtx1 in 111 POAG eyes, divided into three groups according to the severity of disease and 70 healthy eyes in correlation of structural defects in retinal nerve fibre layer and visual fields defects. Results: Compared with the control group, the POAG groups showed significantly smaller TD and LD values (p<0,05) and significantly higher WLR and WT values (p<0,05) for supratemporal and infratemporal arterioles. Rtx1 parameters significantly correlated with OCT parameters (retinal nerve fibre layer, ganglion cell complex and rim area) and visual field parameters (mean deviation and pattern standard deviation) (p<0.05). Conclusion: The results suggest that vascular dysfunction may be involved in POAG pathogenesis and neurodegenerative damage, even at the very early stage of glaucoma, without visual field defects.