The effect of latanoprostene bunod on retinal vessel density in patients with primary open-angle glaucoma

Purpose This study evaluates the efficacy of once-daily administration of 0.024% topical latanoprostene bunod (LBN) ophthalmic solution and its effects on macular vessel density (VD) in patients with primary open-angle glaucoma (POAG). Methods A total of 86 eyes from 43 newly diagnosed POAG patients who had not received prior antiglaucoma treatment were included in this prospective study. Optical coherence tomography angiography (OCTA) was used to assess macular VD before and after LBN treatment. Changes in IOP and VD in the superficial capillary plexus (SCP) and deep capillary plexus (DCP) were analyzed. Results The study included 43 patients (20 males, 23 females) with a mean age of 58.34 ± 15.28 years. After one month of LBN treatment, the mean IOP reduction was 8.3 mmHg, representing a 32.7% decrease. LBN significantly increased VD in both SCP and DCP, especially in the foveal and superior regions ( p < 0.05). A positive correlation was observed between intraocular pressure (IOP) reduction and VD increase in these regions. No significant changes were noted in the temporal, inferior, or nasal regions. Conclusion LBN is an effective and well-tolerated treatment for IOP reduction in treatment-naïve POAG patients. It significantly increases macular VD, particularly in the foveal and superior regions, with VD changes correlating with IOP reduction. These vascular benefits likely result from nitric oxide (NO)-mediated microcirculatory improvements. Larger, long-term multicenter studies are needed to explore LBN's sustained vascular effects in glaucoma management.