Optical Coherence Tomography Angiography in Glaucoma: A Review

Abstract

Background: Glaucoma is the leading cause of irreversible blindness worldwide. Several techniques exist for the diagnosis and follow-up of patients. Optical coherence tomography (OCT) angiography (OCTA) is a recently developed technique that provides a quantitative assessment of the microcirculation of the retina and choroid in a fast, noninvasive way. Despite it being a novel technique, several publications have already been done in the glaucoma field. However, a summary of findings is currently lacking. Aims: To perform a literature review to assess the role of OCTA in glaucoma diagnosis and follow-up. Methods: A database search was carried out using MEDLINE, Embase, and Web of Science, including all original works registered until July 23, 2017. Results: OCTA (1) has a high repeatability and reproducibility, (2) has good discriminatory power to differentiate normal eyes from glaucoma eyes, (3) is more strongly correlated with visual function than conventional OCT, (4) has good discriminatory power to differentiate early-glaucoma eyes from normal eyes (i.e., at least equal to that of OCT), (5) reaches a floor effect at a more advanced disease stage than OCT, and (6) is able to detect progression in glaucoma eyes. Conclusion: OCTA shows potential to become a part of everyday glaucoma management.

<p>Peripapillary Vessel Density In Unilateral Preperimetric Glaucoma</p>

“…Recently, the VD of RPC obtained by OCTA has emerged as a marker of microvascular disturbances associated with optic nerve damage. 8 In the present study, we investigated the superficial capillary density of three defined areas within and around the optic disc in patients with unilateral PPG and in subjects without ocular pathology. As expected, PPG eyes had on average larger C/D area, thinner RNFL and GCC than their fellow eyes.…”

“…Quantitative analysis of the radial peripapillary capillaries (RPC) density can be delivered with high repeatability and reproducibility. 8 The RPC network 9 has recently emerged as a promising area in glaucoma diagnosis, management and research. Many investigators showed that OCTA parameters as vessel density or blood flow index of the RPC were reduced in glaucomatous eyes compared with normal eyes.…”

Neue Chancen bei der Glaukom-Früherkennung mit der optischen Kohärenztomographie-Angiographie

“…Hier sind weitere Studien mit größeren Kollektiven vor allem auch im Verlauf erforderlich. In einer Literaturübersicht der bis Juli 2017 publizierten Arbeiten zur OCT-A fanden van Melkebeke et al [4 ]jedoch eine bessere Korrelation der OCT-A mit funktionellen Parametern als mit der OCT und eine mindestens entsprechende Power zur Diagnosestellung.…”

The diagnostic ability of circulatory measurements from OCTA for glaucoma compared with structural measurements from OCT: A systematic review and meta-analysis

“…However, in which vascular parameters had better diagnostic ability for glaucoma and the comparison with the structural parameters, the results were varied due to many limitations. [11,[19][20][21][22][23][24][25][26] And little studies compared these parameters between glaucoma patients with normal IOP (normal tension glaucoma (NTG)) and those with high IOP(>21mmHg).…”