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PRECIS We found significant differences in macular vascular microcirculation between normal and glaucomatous eyes using optical coherence tomography angiography (OCTA). Macular vascular microcirculation changes also showed significant correlations with visual field (VF) severity classification systems. PURPOSE To correlate VF severity defined by different classification systems and macular vascular microcirculation in eyes with glaucoma using OCTA. PATIENTS AND METHODS Twenty normal and 58 open-angle glaucoma (OAG) eyes were scanned using a swept-source OCTA (Plex Elite 9000) and macular vascular microcirculation was measured by calculating the overall blood flux index (BFI) and vessel area density (VAD) over the entire 6×6 mm area excluding the big retinal vessels. Glaucomatous eyes were staged into severity groups based on 4 VF severity classifications: Hodapp-Parrish-Anderson scale, Glaucoma Severity Staging system, ICD-10 glaucoma staging definitions, and VF mean deviation. Central 10-degree VF mean sensitivity (CMS) was calculated based on 24-2 VF. One-way analysis of variance was used to analyze the differences and correlation between macular vascular microcirculation and other clinical parameters. RESULTS Glaucomatous eyes had significantly lower ganglion cell and inner plexiform layer BFI and VAD (P

PReCIS:: We found no significant differences in peripapillary and macula microcirculation blood flow metrics in eyes with open angle glaucoma of African descent (AD) and European Descent (ED) as detected by optical coherence tomography-angiography (OCTA). Purpose To investigate the peripapillary retinal nerve fiber layer (RNFL) and macular vascular microcirculation in subjects of African descent (AD) and European descent (ED) with open-angle glaucoma using optical coherence tomography-angiography (OCTA). Patients and methods One eye from each subject was scanned using AngioPlex OCTA system (Zeiss Meditec Inc., Dublin, CA) covering both a 6 ×6▒mm scanning area centered at the optic nerve head (ONH) and at the foveola. Peripapillary RNFL and macular microcirculation were measured by calculating the overall flux and vessel area density excluding the large retinal vessels. Two-sample, independent t-tests were used to compare the OCTA metrics between AD and ED eyes. Linear regression models were used to investigate the correlation between OCTA metrics and structural and functional parameters. Results Twenty-eight eyes of AD and 56 eyes of ED were included in the study. There was no significant difference in age, sex, hypertension, anti-hypertensive medications, diabetes, systolic and diastolic blood pressure, mean ocular perfusion pressure, RNFL thickness and visual field (VF) mean deviation (MD) and VF pattern standard deviation (PSD) (P≥0.054) between AD and ED eyes included. Both groups had similar OCTA blood flow metrics (P≥0.161). OCTA blood flow metrics were significantly correlated with VF MD (r≥0.466), VF PSD (r≤-0.366) and RNFL thickness (r≥0.333). Conclusions No significant differences were found in peripapillary and macular microcirculation detected by OCTA between AD and ED glaucomatous eyes. Peripapillary and macular microcirculation were significantly correlated with disease severity in AD and ED glaucomatous eyes.

PURPOSE To produce an internationally valid tool to assess skill in performing trabeculectomy surgery. METHODS A panel of 5 experts developed a tool for assessing trabeculectomy surgery by using a modified Dreyfus scale of skill acquisition and providing descriptors for each level of skill for each category. The tool was then reviewed by a panel of 10 international content experts for their constructive comments, which were incorporated into the final rubric tool. RESULTS A final rubric, incorporating the suggestions of the international panel, published here as the ICO-OSCAR: Trabeculectomy. CONCLUSIONS The tool ICO-OSCAR: Trabeculectomy has content and face validity. It can be used internationally to assess trabeculectomy surgery skill. Predictive and construct validity, and reliability are yet to be determined.

PURPOSE To evaluate continued visual field (VF) progression in eyes with prior VF progression from open-angle glaucoma, using event-based criteria. METHODS Retrospective observational case series of 70 eyes (70 patients) with open-angle glaucoma, treated for at least 2 years, that had earlier shown 1 step of VF progression. Further VF progression required a worsening of 3 adjacent points at the same location on 2 consecutive VF tests. Potential risk factors for continued progression were evaluated. RESULTS The mean follow-up was 127±43 months. Thirty-seven eyes (55%) continued to progress. At 5, 10, and 15 years after the initial VF, the Kaplan-Meier estimate of the risk of developing 2 steps of progression was 18%, 53%, and 71%. A shorter time to the first step of progression was significantly associated with further progression (P