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To correlate finger blood flow and changes in optic nerve head (ONH) blood flow following therapeutic intraocular pressure (IOP) reduction in open-angle glaucoma (OAG) and ocular hypertension (OHT).Seventeen open-angle glaucoma patients and nineteen ocular hypertension patients underwent therapeutic IOP reduction followed by a minimum of 4 weeks of follow-up. Optic nerve head blood flow measurements were obtained by scanning laser Doppler flowmetry using full-field perfusion image analysis. Finger blood flow was measured using the Transonic laser Doppler Flowmeter. Finger blood flow was measured at baseline, after immersion in warm water (40°C) for 2 minutes (Flow Max), and after immersion in cold water (4°C) for 10 seconds (Flow Min). Patients were identified as vasospastic if their Flow Max/Flow Min >7. Statistical comparisons were performed using two-tailed distribution paired T-test and Pearson's correlation factor.For similar mean percentage intraocular pressure reduction, vasospastic patients had greater improvements in rim blood flow than did non-vasospastic patients [+35% versus +13%] (P= 0.01). While there was no difference in rim blood flow changes in the vasospastic versus the non-vasospastic OAG group, the vasospastic ocular hypertension group showed 18% increase in rim blood flow whereas the non-vasospastic ocular hypertension group showed an 8% decrease. A significant negative correlation was also found in the open-angle glaucoma group between rim blood flow change and Flow Max (−0.681, P= 0.003). In contrast, no such correlation was found in the ocular hypertension group (+0.144, P= 0.556).OAG patients had a significant negative correlation between changes in rim blood flow and maximum finger Doppler flow. Among ocular hypertension patients, increased rim blood flow was only found in the vasospastic group, though this increase was not statistically significant. These results suggest that open-angle glaucoma and ocular hypertension patients with the most severe vasospastic disease may show the greatest improvements in rim blood flow after sustained intraocular pressure reduction.