Measuring Glaucomatous Focal Perfusion Loss in the Peripapillary Retina Using OCT Angiography

Chen, Aiyin; Liu, Liang; Wang, Jie; Zang, Pengxiao; Edmunds, Beth; Lombardi, Lorinna; Davis, E. A.; Morrison, John C.; Jia, Yali; Huang, David

doi:10.1016/j.ophtha.2019.10.041

Cited by 20 publications

(23 citation statements)

References 43 publications

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“…Another OCTA outcome measure was the low-perfusion area (LPA). The low-perfusion map and LPA assessed the location and severity of focal glaucoma damage with good agreement with VF 29 . Low perfusion was defined as CD below the 0.5 percentile normative threshold in a contiguous area of at least 0.053 mm 2 (98.5 normative cutoff).…”

Section: Methodsmentioning

confidence: 89%

“…The original Garway-Heath scheme divided the disc rim into 6 sectors 53 , 54 . We added horizontal dividing lines to the original nasal and temporal sectors to increase the total number of sectors to 8 29 . The sector boundaries were extended outward along nerve fiber trajectories obtained from structural OCT nerve fiber flux analysis 55 .…”

Section: Methodsmentioning

confidence: 99%

“…This is of interest as retinal perfusion could be linked to ganglion cell metabolism and function. Our group has recently developed new methods for assessing focal perfusion changes in the nerve fiber layer plexus (NFLP), the plexus most affected by glaucoma in the peripapillary region 15 , 29 , 30 . In this study, we applied these new tools to investigate the extent, location, and timing of perfusion recovery following surgery.…”

Section: Introductionmentioning

confidence: 99%

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Optical coherence tomographic angiography study of perfusion recovery after surgical lowering of intraocular pressure

Liu

Takusagawa

Greenwald

et al. 2021

Sci Rep

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We investigated the time and location of retinal perfusion recovery after surgical intraocular pressure (IOP) lowering in glaucoma by using optical coherent tomography angiography (OCTA). Seventeen patients were analyzed. The 4.5 × 4.5-mm OCTA scans centered on the disc were performed preoperatively and postoperatively at 6 weeks, 3 months, and 6 months. The peripapillary retinal nerve fiber layer (NFL) thickness, NFL plexus capillary density (NFLP-CD) and visual field (VF) were measured overall and in 8 corresponding sectors. The low-perfusion area (LPA) was used to assess the cumulative area where local NFLP-CD was significantly below normal. At 6 months, the average IOP decreased 5.3 mmHg (P = 0.004), LPA decreased by 15% (P = 0.005), and NFLP-CD improved by 12% (P < 0.001). The NFL thickness and VF mean deviation didn’t change significantly at any time point. Among the sectors with significant preoperative NFLP-CD loss, the recovery at 6 months was greatest in sectors with minimal preoperative NFL thinning (P < 0.001). In conclusion, surgical IOP lowering may improve NFLP capillary perfusion after 6 months. The perfusion recovery tended to occur in areas with minimal NFL thinning at baseline. OCTA parameters may have potential usefulness as pharmacodynamic biomarkers for glaucoma therapy.

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Section: Methodsmentioning

confidence: 89%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Optical coherence tomographic angiography study of perfusion recovery after surgical lowering of intraocular pressure

Liu

Takusagawa

Greenwald

et al. 2021

Sci Rep

Self Cite

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“…This not only demonstrates that tissue oxygenation can be derived from capillary sO 2 , it illustrates that capillary sO 2 can provide level-specific information on retinal oxygenation. This could be particularly valuable in diseases where some layers of the retina are preferentially damaged, as in glaucoma, which primarily affects the nerve fiber layer and retinal ganglion cells and in which inner retinal capillary dropout has been documented (44).…”

Section: Discussionmentioning

confidence: 99%

Retinal capillary oximetry with visible light optical coherence tomography

Hormel

Wei

et al. 2020

Proc. Natl. Acad. Sci. U.S.A.

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Assessing oxygen saturation (sO2) remains challenging but is nonetheless necessary for understanding retinal metabolism. We and others previously achieved oximetry on major retinal vessels and measured the total retinal oxygen metabolic rate in rats using visible-light optical coherence tomography. Here we extend oximetry measurements to capillaries and investigate all three retinal vascular plexuses by amplifying and extracting the spectroscopic signal from each capillary segment under the guidance of optical coherence tomography (OCT) angiography. Using this approach, we measured capillary sO2in the retinal circulation in rats, demonstrated reproducibility of the results, validated the measurements in superficial capillaries with known perfusion pathways, and determined sO2responses to hypoxia and hyperoxia in the different retinal capillary beds. OCT capillary oximetry has the potential to provide new insights into the retinal circulation in the normal eye as well as in retinal vascular diseases.

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“…Furthermore, circumpapillary vessel density significantly decreased in glaucomatous eyes (Chen et al, 2017). Chen et al (2020) demonstrated that eyes with POAG had more areas of low perfusion in the peripapillary layer than controls and greater areas of focal perfusion loss (Chen et al, 2020). Notably, Mammo et al (2016) found that vessel density significantly decreased in the radial peripapillary layer in the glaucomatous eye of patients with unilateral glaucoma compared with the unaffected eye, glaucoma suspects and healthy controls (Mammo et al, 2016).…”

Section: Optic Nerve Head and Peripapillary And Circumpapillary Capil...mentioning

confidence: 98%

Vascular biomarkers from optical coherence tomography angiography and glaucoma: where do we stand in 2021?

Shin

Wolf

Harris

et al. 2021

Acta Ophthalmologica

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Biomarkers of ocular blood flow originating from a wide variety of imaging modalities have been associated with glaucoma onset and progression for many decades. Advancements in imaging platforms including optical coherence tomography angiography (OCTA) have provided the ability to quantify vascular changes in glaucoma patients, alongside traditional measures such as retinal nerve fibre layer thickness and optic nerve head structure. Current literature on vascular biomarkers, as measured by OCTA, indicates significant relationships between glaucoma and blood flow and capillary density in the retina and ONH. The data currently available, however, are highly diverse and lack robust longitudinal data on OCTA vascular outcomes and glaucoma progression. Herein we discuss and summarize the relevant current literature on OCTA vascular biomarkers and glaucoma reviewed through March 1, 2021. Associations between OCTA vascular biomarkers and clinical structural and functional glaucoma outcomes as well as differences between glaucoma patients and healthy controls are reviewed and summarized. The available data identify significantly decreased flow density, flow index and vessel density in the ONH, peripapillary vascular layer and macula of glaucoma patients compared with controls. Whole image vessel density is also significantly decreased in glaucoma patients compared with controls, and this outcome has been found to correspond to severity of visual field loss. OCTA vascular biomarkers alongside clinical structural outcomes may aid in assessing overall risk for glaucoma in patients.

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Measuring Glaucomatous Focal Perfusion Loss in the Peripapillary Retina Using OCT Angiography

Cited by 20 publications

References 43 publications

Optical coherence tomographic angiography study of perfusion recovery after surgical lowering of intraocular pressure

Optical coherence tomographic angiography study of perfusion recovery after surgical lowering of intraocular pressure

Retinal capillary oximetry with visible light optical coherence tomography

Vascular biomarkers from optical coherence tomography angiography and glaucoma: where do we stand in 2021?

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