Optical coherence tomography angiography: A new tool in glaucoma diagnostics and research

Daneshvar, Ramin; Nouri‐Mahdavi, Kouros

doi:10.4103/jovr.jovr_36_17

Cited by 8 publications

(7 citation statements)

References 70 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although the exact pathogenesis is unknown, there is well-established evidence that vascular changes and insufficient blood flow to the optic nerve contribute to the development and progression of disease 7–10. Recent studies using optical coherence tomography angiography (OCTA), a noninvasive imaging modality that can assess microvascular structure and function, have demonstrated decreased peripapillary vascular perfusion and capillary vessel density (VD) in glaucomatous eyes that worsen with increasing severity of disease 11–17. Notably, the vast majority of OCTA studies on glaucoma do not distinguish between normal-tension glaucoma (NTG) and primary open-angle glaucoma (POAG), and the few studies that do have focused primarily on the optic disc and peripapillary vasculature 18,19…”

Section: Introductionmentioning

confidence: 99%

<p>Parafoveal vessel changes in primary open-angle glaucoma and normal-tension glaucoma using optical coherence tomography angiography</p>

Onishi¹,

Treister²,

Nesper³

et al. 2019

OPTH

View full text Add to dashboard Cite

PurposeTo evaluate parafoveal and peripapillary perfusion in healthy, glaucoma suspect, normal-tension glaucoma, and primary open-angle glaucoma subjects.Patients and methodsThis was a retrospective cross-sectional study with optical coherence tomography angiography imaging with RTVue XR Avanti (Optovue, Inc., Fremont, CA) of 56 eyes (14 healthy, 14 glaucoma suspect, 16 normal-tension glaucoma, and 12 primary open-angle glaucoma) at a tertiary academic referral center. Parafoveal and peripapillary superficial vessel density and parafoveal superficial retinal thickness were the main parameters of interest. Area under receiver operating characteristic curves were calculated.ResultsThere were significant decreases in parafoveal superficial vessel density in primary open-angle (40.06±4.54%, P<0.001) and normal-tension glaucoma (42.82±5.16%, P=0.010) but not suspect eyes (45.72±4.37%, P=0.916) compared to healthy eyes (48.10±2.82%). Similarly, decreases were observed in parafoveal inner retinal thickness in primary open-angle (83.19±14.29 μm, P<0.001) and normal-tension glaucoma eyes (94.97±12.44 μm, P=0.035), but not suspect eyes (99.93±9.00 μm, P=0.648), compared to healthy controls (107.00±9.55 μm). Only primary open-angle glaucoma eyes displayed significant changes in peripapillary vessel density (37.63±7.19%) compared to healthy controls (49.12±2.80%, P<0.001). Further statistical adjustment for sex and age revealed a significant decrease in parafoveal vessel density in suspects relative to controls (P=0.039). Diagnostic accuracy of parafoveal vessel density was high with an area under the curve of 0.833±0.073 for normal-tension glaucoma and 0.946±0.049 for primary open-angle glaucoma.ConclusionParafoveal vessel density was significantly reduced in glaucomatous eyes, with good diagnostic accuracy. These findings provide further evidence that these changes may be useful in the diagnosis and monitoring of disease in glaucoma patients.

show abstract

Section: Introductionmentioning

confidence: 99%

<p>Parafoveal vessel changes in primary open-angle glaucoma and normal-tension glaucoma using optical coherence tomography angiography</p>

Onishi¹,

Treister²,

Nesper³

et al. 2019

OPTH

View full text Add to dashboard Cite

show abstract

“…However, OCTA is extremely vulnerable to multiple artefacts, including motion, projection, shadow, superficial vessels, vitreous opacities, pigment epithelial detachment, and blinking artefacts. In contrast to FFA and ICGA, interestingly OCTA cannot detect vascular leak [39]. Therefore, it is certain that new OCTA modalities need to be developed to eliminate existing deficiencies and artefacts in the near future.…”

Section: Resultsmentioning

confidence: 99%

Optical coherence tomography angiography for glaucoma diagnosis and observation

2020

Ann Clin Anal Med

View full text Add to dashboard Cite

Glaucoma is a neurodegenerative optic neuropathy characterized by loss of retinal ganglion cells (RGCs) and RGCs axons, resulting in atrophy of the optic nerve. Optical coherence tomography angiography (OCTA) is the most recent modality in ophthalmic imaging field for diagnosis of different ophthalmic disorders, providing a high-resolution view of the vascular structures in the retina and optic nerve head. OCTA provides three-dimensional (3D) vascular information with the detection of motion contrast from the blood flow and an advanced approach to visualize retinal vasculature without the need of any dye injections that are non-invasive, fast and reproducible. In contrast to fluorescein angiography (FA) and indocyanine green angiography (ICGA), OCTA is a fast, safe, non-invasive and cost-effective diagnostic method. Another substantial superiority of the OCTA over FA and ICGA methods is that it provides high-resolution, depth-resolved blood flow data and segments the vascular layers in slabs of varying thickness in a few seconds. In addition, OCTA is a reliable and objective imaging technique with high reproducibility compared to the visual field (VF) testing. OCTA is also faster than VF testing and is less dependent on patient collaboration. Given the current population growth trends and hence the increase in glaucoma prevalence, the analysis of FA and ICGA images or VA testing is more likely to be time-consuming, costly, and prone to adverse effects. Therefore, these challenges can only be solved with the help of potentially promising diagnostic analyzes.

show abstract

“…One important unresolved question in the field relates to whether vascular changes precede structural changes or whether loss of the retinal ganglion cells and their decreased metabolic need leads to the reduced blood flow observed with OCTA. 100 In their longitudinal OCTA study, Shoji and colleagues 101 demonstrated that the average rate of decline in macular vessel density over the course of at least 1 year was significantly higher in glaucomatous eyes than healthy or glaucoma suspect eyes. Interestingly, these authors found no significant decline in ganglion cell layer thickness in any of the three groups over the same time period.…”

Section: Study Of Posterior Pole Diseasementioning

confidence: 99%

An overview of optical coherence tomography angiography and the posterior pole

Onishi

Fawzi

2019

Ophthalmol Eye Dis

View full text Add to dashboard Cite

Optical coherence tomography angiography is a relatively new, noninvasive technology that has revolutionized imaging of the retinal and choroidal microvasculature. This technology is based on the detection of movement or changes that represent moving red cells in sequential optical coherence tomography scans. As with other established imaging technologies, it has unique benefits as well as certain disadvantages, which include a limited field of view and vulnerability to imaging artifacts. However, software and hardware improvements are continually evolving to mitigate these limitations. Optical coherence tomography angiography has been used to gain a better understanding of microvascular changes across a spectrum of ocular diseases including diabetic retinopathy, age-related macular degeneration, glaucoma, and retinal vein occlusions. In this article, we review algorithms and techniques commonly utilized in optical coherence tomography angiography systems and compare optical coherence tomography angiography to fluorescein angiography, the current gold standard for imaging the retinal vasculature. In addition, we provide an overview of important optical coherence tomography angiography findings in a variety of ocular diseases. Although the clinical role of this technology is still poorly defined, optical coherence tomography angiography has the potential to become an invaluable tool in the diagnosis and monitoring of vascular pathologies.

show abstract

Optical coherence tomography angiography: A new tool in glaucoma diagnostics and research

Cited by 8 publications

References 70 publications

<p>Parafoveal vessel changes in primary open-angle glaucoma and normal-tension glaucoma using optical coherence tomography angiography</p>

<p>Parafoveal vessel changes in primary open-angle glaucoma and normal-tension glaucoma using optical coherence tomography angiography</p>

Optical coherence tomography angiography for glaucoma diagnosis and observation

An overview of optical coherence tomography angiography and the posterior pole

Contact Info

Product

Resources

About