Optical Coherence Tomography Angiography of Optic Disc and Macula Vessel Density in Glaucoma and Healthy Eyes

Abstract

Aim: To study the microvascular density of the macular and optic nerve head in healthy and glaucoma subjects using optical coherence tomography angiography. Methodology: We performed a cross-sectional cohort study on healthy subjects and patients with glaucoma. The AngioVue Enhanced Microvascular Imaging System was used to capture the optic nerve head and macula images during one visit. En face segment images of the macular and optic disc were studied in layers. Microvascular density of the optic nerve head and macula were quantified by the number of pixels measured by a novel in-house developed software. Areas under the receiver operating characteristic curves (AUROC) were used to determine the accuracy of differentiating between glaucoma and healthy subjects. Results: A total of 24 (32 eyes) glaucoma subjects (57.5±9.5-y old) and 29 (58 eyes) age-matched controls (51.17±13.5-y old) were recruited. Optic disc and macula scans were performed showing a greater mean vessel density (VD) in healthy compared with glaucoma subjects. The control group had higher VD than the glaucoma group at the en face segmented layers of the optic disc (optic nerve head: 0.209±0.05 vs. 0.110±0.048, P<0.001; vitreoretinal interface: 0.086±0.045 vs. 0.052±0.034, P=0.001; radial peripapillary capillary: 0.146±0.040 vs. 0.053±0.036, P<0.001; and choroid: 0.228±0.074 vs. 0.165±0.062, P<0.001). Similarly, the VD at the macula was also greater in controls than glaucoma patients (superficial retina capillary plexus: 0.115±0.016 vs. 0.088±0.027, P<0.001; deep retina capillary plexus: 0.233±0.027 vs. 0.136±0.073, P<0.001; outer retinal capillary plexus: 0.190±0.057 vs. 0.136±0.105, P=0.036; and choriocapillaris: 0.225±0.053 vs. 0.153±0.068, P<0.001. The AUROC was highest for optic disc radial peripapillary capillary (0.96), followed by nerve head (0.92) and optic disc choroid (0.76). At the macula, the AUROC was highest for deep retina (0.86), followed by choroid (0.84), superficial retina (0.81), and outer retina (0.72). Conclusions: Microvascular density of the optic disc and macula in glaucoma patients was reduced compared with healthy controls. VD of both optic disc and macula had a high diagnostic ability in differentiating healthy and glaucoma eyes.

Potential mechanisms of retinal ganglion cell type‐specific vulnerability in glaucoma

“…Optical coherence tomography angiography has demonstrated all retinal capillary layers in glaucoma patients demonstrated reduced vessel density. 93 Animal models demonstrate similar vasculature abnormalities; however, it is unclear whether these changes are a cause or a consequence of RGC functional loss. Capillary volume is decreased in primates following months of moderate IOP.…”

OCTA Multilayer and Multisector Peripapillary Microvascular Modeling for Diagnosing and Staging of Glaucoma

“…Although the OCTA data, in their raw form, are provided in three dimensions, the twodimensional data created from projections between specific depths are often used. Coronal projections of different layers (superficial vascular plexus, 31,57,58 deep vascular plexus, 31,59,60 whole retina, 21,61 choriocapillaris, 61 and choroid 61,62 ) have been studied individually. However, to the best of our knowledge, no one has reported whether including information from multiple layers at the peripapillary region has an added value for the glaucoma classification.…”

A comparative study of structural and microcirculatory parameters in patients with primary open-angle glaucoma and diabetes mellitus

“…Yip и соавт. [10] выявили при глаукоме снижение плотности сосудов как в перипапиллярной, так и в макулярной зонах, ассоциацию параметров OКT-A с частотой снижения толщины RNFL у пациентов с ПОУГ от легкой до умеренной степени тяжести, наблюдаемых по мере прогрессии заболевания. Результаты нашего исследования гемодинамики при I стадии ПОУГ показали только статистически значимое снижение средней плотности сосудов в нижнем (0,39 ± 0,04 / мм) и височном секторах (0,39 ± 0,06 / мм) на фоне статически не значимого ухудшения показателей перфузии в абсолютных цифрах (р  0,05).…”