OCT-angiography detects longitudinal microvascular changes in glaucoma: a systematic review

Miguel, Ana; Silva, André; Breda, João Barbosa; Azevedo, Luís Filipe; Abdulrahman, Abdulkarim; Hereth, Esther; Pinto, Luís Abegão; Lachkar, Yves; Stalmans, Ingeborg

doi:10.1136/bjophthalmol-2020-318166

Cited by 21 publications

(25 citation statements)

References 38 publications

(119 reference statements)

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“…Recent studies have focused on the application of OCT and OCTA on the early detection of development and progression in glaucoma suspects and patients. Specifically, the longitudinal structural and vascular metrics changes have been frequently studied ( 43 , 44 ). In the early diagnosis of glaucoma, both ONH, RNFL, and macular parameters have shown a high level of value ( 44 ).…”

Section: Discussionmentioning

confidence: 99%

Change of Retinal Vessel Density After Lowering Intraocular Pressure in Ocular Hypertension

Chen

Hong

et al. 2021

Front. Med.

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Purpose: To investigate the relationship between retinal microvasculature changes and intraocular pressure (IOP) for ocular hypertension (OHT) patients and further assess the factors associated with retinal microcirculation changes.Methods: This was a single-center prospective study designed for OHT patients, which consisted of two visits. After collecting baseline data of those who met the eligibility criteria, these patients were treated with latanoprost 0.005% ophthalmic solution for 4 weeks. Peripapillary vessel density (VD) of radial peripapillary capillaries (RPC) layer, macular VD in both superficial and deep layers, and foveal avascular zone (FAZ) area were measured by optical coherence tomography angiography (OCTA) before and after the treatment. We compared the changes in IOP and VD among the two visits by paired-sample t-test. Bonferroni correction was applied. Factors associated with VD changes were analyzed by linear regression analysis.Results: Thirty-four eyes of thirty-four patients were included. The mean IOP decreased by 6.5 ± 2.2 mmHg (p < 0.001). The peripapillary RPC VD increased significantly from 51.8 ± 2.5 to 53.0 ± 3.1% (Adjusted-p = 0.012). We found no significant difference in detailed sectors of the peripapillary region after correction. In the macular area, both the superficial and deep layers in foveal (superficial: 0.2 ± 1.9%, p = 0.523; deep: 0.0 ± 2.3%, p = 0.969) and parafoveal (superficial: 0.3 ± 3.0%, p = 0.565; deep: 0.5 ± 3.1%, p = 0.423) VD remained unchanged. The decrease of the mean FAZ area was insignificant (p = 0.295). The percentage of IOP reduction (β = 0.330, p = 0.031) and the baseline RNFL thickness (β = 0.450, p = 0.004) significantly correlated with the percentage of peripapillary RPC VD improvement in the multivariate linear regression analysis.Conclusion: The peripapillary VD in OHT patients increased after the reduction of IOP. The mild change of IOP did not alter the microcirculation in the macula. In addition, the percentage of IOP change and the baseline RNFL thickness were independent factors for the peripapillary RPC VD improvement.

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Section: Discussionmentioning

confidence: 99%

Change of Retinal Vessel Density After Lowering Intraocular Pressure in Ocular Hypertension

Chen

Hong

et al. 2021

Front. Med.

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“…A reduction in optic disc vessels in the glaucomatous subjects when compared with normal subjects has been previously observed using angio-optical coherence tomography (OCT) 10 21. A recent review elucidated the need for comprehensive longitudinal studies in this regard 22…”

Section: Discussionmentioning

confidence: 92%

“…10 21 A recent review elucidated the need for comprehensive longitudinal studies in this regard. 22 The present paper is oriented towards the previous mentioned goal, focusing on longitudinal changes in optic disc vessels in patients with diabetes with and without signs of glaucoma. Vascular reduction in peripapillary vessels has been previously reported in patients with diabetes and is related to the degree of retinopathy.…”

Section: Discussionmentioning

confidence: 99%

Comparison of age-related vascular changes in the optic disc of patients with diabetes, with glaucomatous and non-glaucomatous features

et al. 2022

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ObjectiveTo identify age-related vascular changes in the optic discs of patients with diabetes with and without signs of glaucoma.Methods and analysisA total of 2153 eyes of 1797 patients with diabetes without significant retinopathy were monitored with 10 Topcon-NW400 images obtained over 10.27±1.58 years. 571 non-diabetics eyes were selected as controls. Laguna ONhE uses convolutional neural networks to identify optic disc edges, vessels, cup and rim, and provides a glaucoma assessment index—Globin Distribution Function (GDF).ResultsIn the first image, vessel pixels accounted for 33.88% of the disc area (SD=3.72) in non-glaucoma (DN) and 31.35% (SD=4.05; p<0.0001) in glaucoma cases (DG). This number of pixels was reduced by −0.55% each year (SD=0.77) in the DN and −0.76% (SD=0.86; p=0.0014) in the DG. In the first image, 76.55% of the disc pixels (SD=11.13) belonged to the rim in the DN and 62.05% (SD=11.00; p=0.0014) in the DG, decreasing annually by −0.33% (SD=0.99) in the DN and −0.68% (SD=1.08; p<0.00001) in the DG groups. All rim sectors were reduced over time in the DG group, particularly superotemporal (41°–80°) and inferotemporal (271°–310°). The reduction was smaller in DN, presenting as progressive thickening of the temporal sector (311°–40°). No changes in age were observed in healthy controls.ConclusionPatients with diabetes show progressive reduction of vessels and neuroretinal rim at the optic disc, which is more intense in association with glaucoma. In the absence of glaucoma, the temporal sector of the diabetic rim was not reduced but thickened, displacing the cup nasally.

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“…Lower blood flow and VD at the optic disc correlates with glaucoma severity in terms of visual field mean deviation, ganglion cell complex thickness and retinal nerve fiber layer (RNFL) thickness (34). VD is also shown to decrease faster in glaucomatous eyes than in their normal counterparts (35). Even within glaucoma subclasses, the reduction in peripapillary VD is apparent in both NTG and POAG separately (36,37).…”

Section: Discussionmentioning

confidence: 99%

Normal tension glaucoma: A dynamic optical coherence tomography angiography study

Eijgen

Heintz²,

Pluijm³

et al. 2023

Front. Med.

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PurposeVascular dysregulation seems to play a role in the pathogenesis of glaucoma, in particular normal tension glaucoma (NTG). The development of optical coherence tomography angiography (OCTA) enabled the measurement of the retinal microvasculature non-invasively and with high repeatability. Nonetheless, only a few studies transformed OCTA into a dynamic examination employing a sympathomimetic stimulus. The goal of this study was to use this dynamic OCTA exam (1) to differentiate healthy individuals from glaucoma patients and (2) to distinguish glaucoma subcategories, NTG and high-tension primary open angle glaucoma (POAG).MethodsRetinal vessel density (VD) in NTG patients (n = 16), POAG patients (n = 12), and healthy controls (n = 14) was compared before and during a hand grip test with a hydraulic dynamometer.ResultsAt baseline, mean peripapillary VD was lower in POAG and NTG (42.6 and 48.5%) compared to healthy controls (58.1%; p < 0.001) and higher in NTG compared to POAG (p = 0.024) when corrected for mean arterial pressure (MAP). Peripapillary and macular (superficial and deep) VD differences were found for gender, age, and baseline MAP. No change in VD occurred (pre-/post-stimulus) in any of the groups.ConclusionRetinal VD loss in glaucoma patients was confirmed and the necessity to correct for gender, age and especially MAP was established. Although replication in a larger population is necessary, OCTA might not be the most suitable method to dynamically evaluate the retinal microvasculature.

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OCT-angiography detects longitudinal microvascular changes in glaucoma: a systematic review

Cited by 21 publications

References 38 publications

Change of Retinal Vessel Density After Lowering Intraocular Pressure in Ocular Hypertension

Change of Retinal Vessel Density After Lowering Intraocular Pressure in Ocular Hypertension

Comparison of age-related vascular changes in the optic disc of patients with diabetes, with glaucomatous and non-glaucomatous features

Normal tension glaucoma: A dynamic optical coherence tomography angiography study

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