{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T20:08:15Z","timestamp":1784664495130,"version":"3.55.0"},"reference-count":30,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T00:00:00Z","timestamp":1766448000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"European Union-NextGenerationEU","award":["BG-RRP-2.004-0009-C02"],"award-info":[{"award-number":["BG-RRP-2.004-0009-C02"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background: Optical coherence tomography angiography (OCT-A) provides quantitative assessment of retinal and peripapillary microvasculature and has emerged as a promising tool for glaucoma diagnostics. However, its sensitivity for detecting early glaucomatous progression over short intervals remains uncertain. This study evaluated cross-sectional and short-term longitudinal OCT-A vessel density (VD) metrics in primary open-angle glaucoma (POAG) and explored their relationships with structural (RNFL) and functional (MD) measures. Methods: Sixty eyes (30 POAG, 30 controls) underwent baseline and 6-month examinations including intraocular pressure (IOP), standard automated perimetry (SAP), structural OCT, and OCT-A (RTVue XR Avanti; AngioVue). Parameters analyzed included peripapillary VD (PP-VD), parafoveal VD (PF-VD), foveal avascular zone (FAZ) metrics, FD-300, and RNFL thickness. Between-group comparisons used t-tests or Mann\u2013Whitney U tests. Effect sizes (Cohen\u2019s d), 95% confidence intervals (CI), and ANCOVA models (adjusted for baseline, age, and sex) were included. Longitudinal change was defined as \u0394 = 6 months \u2212 baseline. Pearson correlations evaluated structure\u2013vascular associations. Results: At baseline, POAG eyes showed significantly lower PP-VD, PF-VD, thinner RNFL, and worse MD (all p &lt; 0.001). Strong correlations were observed between RNFL and PP-VD (r \u2248 0.7). Over 6 months, glaucoma eyes showed small but statistically significant reductions in RNFL (\u0394 = \u22121.04 \u00b5m), MD (\u0394 = \u22120.10 dB), and PP-VD (\u0394 = \u22120.57%), whereas controls remained stable. However, the absolute OCT-A changes were small and largely within the known range of test\u2013retest variability. ANCOVA demonstrated a significant adjusted group effect only for PP-VD (B = \u22121.22%, 95% CI \u22121.53 to \u22120.90; p &lt; 0.001). Conclusions: OCT-A demonstrated clear cross-sectional differences between POAG and controls and strong structure\u2013vascular associations. However, with only two measurements over a 6-month interval, the study cannot distinguish true glaucomatous progression from physiological or device-related variability. Short-term changes should therefore be interpreted cautiously. PP-VD remains the most robust and consistent OCT-A parameter, but larger, longer, and prospectively powered studies are required to validate OCT-A as a reliable biomarker for progression.<\/jats:p>","DOI":"10.3390\/diagnostics16010035","type":"journal-article","created":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T14:05:22Z","timestamp":1766498722000},"page":"35","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Evaluation of OCT Angiography Parameters as Biomarkers for Glaucoma Progression"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6454-554X","authenticated-orcid":false,"given":"Konstantina","family":"Kancheva","sequence":"first","affiliation":[{"name":"Prof. D-r Paraskev Stojanov, Medical University Varna, 9002 Varna, Bulgaria"},{"name":"Faculty of Medicine, University \u201cProf Dr Asen Zlatarov\u201d, 8010 Burgas, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2786-2159","authenticated-orcid":false,"given":"Mladena","family":"Radeva","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Medical University Varna, 9002 Varna, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Igor B.","family":"Resnick","sequence":"additional","affiliation":[{"name":"Prof. D-r Paraskev Stojanov, Medical University Varna, 9002 Varna, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5169-7878","authenticated-orcid":false,"given":"Zornitsa","family":"Zlatarova","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Visual Sciences, Faculty of Medicine, Medical University, 9002 Varna, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1901","DOI":"10.1001\/jama.2014.3192","article-title":"The pathophysiology and treatment of glaucoma: A review","volume":"311","author":"Weinreb","year":"2014","journal-title":"JAMA"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1136\/bjo.2005.081224","article-title":"The number of people with glaucoma worldwide in 2010 and 2020","volume":"90","author":"Quigley","year":"2006","journal-title":"Br. 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