PRIMARY ANGLE-CLOSURE GLAUCOMA (PACG), especially acute PACG, is a significant cause of

blindness. It is estimated that the number of people with PACG worldwide will increase to 23.4
million in 2020, 76.7% of whom will be Asian.

PACG accounted for bilateral irreversible blindness in 3.9 million people in 2010, and this number is
predicted to reach approximately 5.3 million worldwide by 2020.

The 2 principal mechanisms of glaucomatous optic neuropathy and vision loss are mechanical
compression and vascular insufficiency.

It is generally accepted that mechanical compression is the main mechanism of PACG, especially
acute PACG.

Previous studies have paid little attention to the vascular factors in PACG.

These factors play a significant role in the development of damage in primary open-angle glaucoma
(POAG) especially in normal tension glaucoma (NTG). Vascular factors may be involved in the
pathogenesis of PACG and need further exploration.

The microcirculation of the optic nerve head (ONH) can be observed and quantitatively analyzed
with several technologies.

A recent innovation, optical coherence tomography angiography (OCTA), can quantify the retinal and
disc microcirculation in a rapid and accurate way. It is noninvasive, requiring no injection of any
exogenous dye, and provides quantitative analysis of perfusion down to the capillary level.

With this technology, several studies of POAG eyes showed that the microvascular network around
the disc was globally and focally attenuated and the peripapillary vessel density (VD) was reduced.

Further, in POAG eyes, the peripapillary flow index and the VD are highly correlated with visual field
(VF) pattern standard. However, there has been no evaluation by OCTA of peripapillary vessel
density and its correlation with other glaucomatous damage in PACG eyes.

In this study, we used OCTA to observe the peripapillary microvascular network in a group of acute
PACG eyes. We also quantified the peripapillary retinal VD and explored the possible correlation
between disc perfusion, neural structure, and visual field loss.