AIM:To observe circumpapillary and macular vessel density(cpVD/MVD), and to evaluate correlations of cpVD/MVD with retinal nerve fiber layer(RNFL)in patients with acute primary angle-closure glaucoma(APACG).METHODS: Patients with monocular APACG(n=29)visited the Affiliated Hospital of Xuzhou Medical University from March 1, 2019 to December 31, 2019 were prospectively enrolled. Moreover, 29 eyes with APACG attack were included in the experimental group to be performed with combined trabeculectomy, and 29 contralateral eyes were served as the control group to receive preventive laser peripheral iridotomy. Changes in the MVD, the cpVD and the thickness of optic nerve fiber layer(RNFL)before operation and 1wk, 1mo, 3mo and 6mo after operation were observed by oraphyptical coherence tomography angiography(OCTA), respectively.RESULTS: Before operation, the experimental group showed lower cpVD in the superotemporal(ST)quadrant and the temporosuperior(TS)quadrant compared with the control group(all P<0.01). In addition, a brief rise was observed in each quadrant of the experimental group 1wk after operation, but with lower cpVD in the supero-nasal(SN)quadrant, the ST quadrant and the TS quadrant than the control group(all P<0.05). Furthermore, 1mo, 3mo and 6mo after operation, there was a steady downward trend in the cpVD and the MVD in each quadrant of the experimental group over time, and the RNFL thickness was increased at first within 6mo after operation, and then gradually thinned, but the RNFL thickness of the experimental group were thinner than those of the control group 6mo after operation. Correlation analysis showed that there was a positive correlation between the cpVD and the RNFL thickness in the SN, ST, temporoinferior(TI), IT, IN and nasoinferior(NI)quadrants in the experimental group 6mo after operation(all P<0.05). CONCLUSION: The RNFL was thickened in the affected eyes in the early stage after acute attack of APACG, and gradually thinned 3-6mo after operation. However, the cpVD was decreased continuously, and there was a correlation between the RNFL thickness and the cpVD 6mo after operation.