{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,9]],"date-time":"2025-11-09T03:51:13Z","timestamp":1762660273765,"version":"3.37.3"},"reference-count":42,"publisher":"BMJ","issue":"2","funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01EY029058"],"award-info":[{"award-number":["R01EY029058"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100005188","name":"Tobacco-Related Disease Research Program","doi-asserted-by":"publisher","award":["T31IP1511"],"award-info":[{"award-number":["T31IP1511"]}],"id":[{"id":"10.13039\/100005188","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100001818","name":"Research to Prevent Blindness","doi-asserted-by":"publisher","award":["Unrestricted Grant"],"award-info":[{"award-number":["Unrestricted Grant"]}],"id":[{"id":"10.13039\/100001818","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Br J Ophthalmol"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:sec><jats:title>Background\/aims<\/jats:title><jats:p>To evaluate the relationship over time between intraocular pressure (IOP) and the rate of macula whole image vessel density (wiVD) loss and whole image ganglion cell complex (wiGCC) thinning in glaucoma<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>From 62 patients in the Diagnostic Innovations in Glaucoma Study, 59 Primary open-angle glaucoma and 27 glaucoma suspect eyes with mean follow-up of 3.2 years were followed. Optical coherence tomography angiography (OCT-A)-based vessel density and OCT-based structural thickness of the same 6\u00d76\u2009mm GCC scan slab were evaluated. Univariable and multivariable linear mixed models were performed for all eyes and also a subset of them in which peak IOP &lt;18\u2009mm Hg to investigate the effect of IOP parameters on the rate of wiVD and wiGCC change.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean baseline visual field mean deviation (95%\u2009CI) was \u22123.3\u2009dB (\u22124.4 to \u20132.1). Higher mean IOP (\u22120.07%\/year per 1\u2009mm Hg (\u22120.14 to \u20130.01), p=0.033), peak IOP (\u22120.07%\/year per 1\u2009mm Hg (\u22120.13 to \u20130.02), p=0.004) and IOP fluctuation (IOP SD) (\u22120.17%\/year per 1\u2009mm Hg (\u22120.32 to 0.02), p=0.026) were associated with faster macular vessel density loss. Faster wiGCC thinning was associated with higher mean IOP (\u22120.05\u2009\u00b5m\/year per 1\u2009mm Hg (\u22120.10 to \u20130.01), p=0.015), peak IOP (\u22120.05\u2009\u00b5m\/year per 1\u2009mm Hg (\u22120.08 to \u20130.02), p=0.003) and IOP fluctuation (\u22120.12\u2009\u00b5m\/year per 1\u2009mm Hg (\u22120.22 to \u20130.01), p=0.032). In eyes with peak &lt;18\u2009mm Hg, faster wiVD progression was associated with higher mean IOP (p=0.042). Faster wiGCC progression was associated with higher mean IOP in these eyes (p=0.025).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>IOP metrics were associated with faster rates of overall macular microvascular loss and also in the eyes with peak IOP &lt;18\u2009mm Hg. Future studies are needed to examine whether additional IOP lowering reduces the rate of microvascular loss in patients with glaucoma.<\/jats:p><\/jats:sec><jats:sec><jats:title>Trial registration number<\/jats:title><jats:p><jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT00221897\">NCT00221897<\/jats:ext-link>.<\/jats:p><\/jats:sec>","DOI":"10.1136\/bjo-2022-322261","type":"journal-article","created":{"date-parts":[[2022,12,19]],"date-time":"2022-12-19T18:20:13Z","timestamp":1671474013000},"page":"181-187","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Intraocular pressure increases the rate of macular vessel density loss in 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