{
  "abstract": "Aims To investigate retinal vascular geometric alterations following intraocular pressure (IOP)-lowering surgery in patients with primary angle closure disease (PACD) and determine associations between IOP reduction magnitude and retinal vascular parameters.Methods This retrospective, self-controlled study included patients with PACD who underwent IOP-lowering surgery at Beijing Tongren Hospital. Retinal vascular parameters were quantitatively measured from fundus photographs before and after surgery using a validated deep learning-based analysis system. Main outcomes included retinal arteriolar and venular calibre, tortuosity, fractal dimension (FD), segment number (N_seg) and vascular density. Linear mixed-effects models, adjusted for age, follow-up interval and PACD subtype, assessed associations between IOP reduction magnitude and vascular parameter changes.Results Among 126 eyes (112 patients), surgery decreased IOP from 35.0±9.9 to 16.7±5.7 mm Hg (p<0.001). Venous FD increased from 1.52±0.06 to 1.53±0.05 (p=0.003), N_seg from 123.50 (IQR: 61.75–182.50) to 153.00 (88.50–185.00) (p=0.007), vessel area density (VAD) from 6.13±1.56 to 6.50±1.34 (p=0.006) and vessel skeleton density (VSD) from 1.24±0.35 to 1.35±0.31 (p=0.003). Vessel calibre and tortuosity showed no significant changes. IOP reduction magnitude was independently associated with changes in venous FD (p=0.023), N_seg (p=0.031), VAD (p=0.012) and VSD (p=0.030).Conclusions Surgical IOP reduction in PACD patients produces selective retinal venous alterations with increased complexity and density. These pressure-responsive changes may provide complementary, non-invasive information regarding vascular response after surgery.",
  "authors": [
    {
      "affiliations": [
        "Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital, Capital Medical University, Beijing, China"
      ],
      "name": "Jin Wang"
    },
    {
      "affiliations": [
        "Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital, Capital Medical University, Beijing, China",
        "Beijing Institute of Ophthalmology, Beijing, China"
      ],
      "name": "Zijian Liu"
    },
    {
      "affiliations": [
        "Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital, Capital Medical University, Beijing, China"
      ],
      "name": "Hui Zhang"
    },
    {
      "affiliations": [
        "Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital, Capital Medical University, Beijing, China",
        "Beijing Institute of Ophthalmology, Beijing, China"
      ],
      "name": "Yue Wang"
    },
    {
      "affiliations": [
        "Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital, Capital Medical University, Beijing, China"
      ],
      "name": "Dapeng Mou"
    },
    {
      "affiliations": [
        "Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital, Capital Medical University, Beijing, China"
      ],
      "name": "Xin Tang"
    },
    {
      "affiliations": [
        "Experimental Ophthalmology, The Hong Kong Polytechnic University, Hong Kong, China"
      ],
      "name": "Shi Danli"
    },
    {
      "affiliations": [
        "Experimental Ophthalmology, The Hong Kong Polytechnic University, Hong Kong, China"
      ],
      "name": "Mingguang He"
    },
    {
      "affiliations": [
        "Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital, Capital Medical University, Beijing, China",
        "Beijing Institute of Ophthalmology, Beijing, China",
        "Henan Academy of Innovations in Medical Science, Zheng Zhou, China"
      ],
      "name": "Wang Ning-Li"
    },
    {
      "affiliations": [
        "Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital, Capital Medical University, Beijing, China"
      ],
      "name": "Ye Zhang"
    }
  ],
  "title": "Retinal vascular alteration following surgical intraocular pressure reduction in primary angle closure disease",
  "uid": "7cd68cce-f706-5ed4-bf80-0bfdd2378ef5"
}