Abstract: Objective To compare the correlation between choroidal vascular parameters and retinal nerve fiber layer(RNFL) thickness in ocular hypertension(OHT) and primary open-angle glaucoma(POAG) using wide-field optical coherence tomography angiography(WF-OCTA) . Methods This single-center, retrospective cross-sectional study included 30 patients who underwent WF-OCTA examination at Beijing Friendship Hospital from January to December 2025. Participants were divided into normal control, OHT and POAG groups with 10 in each. WF-OCTA was used to measure choroidal vascular volume (CVV), choroidal vascular index (CVI) and RNFL thickness in concentric annular regions centered on the fovea (1-6 mm, 6-12 mm, 12-15 mm, 15-18 mm, 18-21 mm). The Kruskal-Wallis test compared group differences. Multiple linear regression analyzed associations between group CVV, CVI, and RNFL thickness, adjusting for age, gender, axial length (AL) and intraocular pressure (IOP) before and after treatment. Interaction effects were tested. Results Significant differences were observed among groups in age, disease duration, number of medications, central corneal thickness and IOP before and after treatment(P＜0.05). Compared with controls, the POAG group showed significantly thinner RNFL thickness and lower CVV in multiple peripheral regions, with higher CVI in some areas (P=0.045). Compared with controls, the OHT group showed no significant RNFL difference but had lower CVV and higher CVI in some regions. After adjustment, post-treatment IOP and axial length were independently negatively correlated with RNFL thickness in multiple regions(P＜0.05). In the central 1-6 mm region, CVI was positively correlated with RNFL thickness(β=448.79,P=0.011),with a significant group-CVI interaction(P＜0.05),indicating attenuated CVI influence on RNFL in OHT and POAG groups. Conclusions WF-OCTA demonstrates that the CVI (particularly in the central 1-6 mm region) is more significant than the CVV, showing a positive correlation with RNFL thickness, which is modulated by disease status. Post-treatment intraocular pressure and axial length are the core factors affecting RNFL thickness.

Key words: primary open-angle glaucoma, ocular hypertension, wide-field optical coherence tomography angiography, choroidal vascular index, retinal nerve fiber layer