Peripapillary perfused capillary density in primary open<b>-</b>angle glaucoma across disease stage<b>:</b>an optical coherence tomography angiography study

Geyman, Lawrence; Garg, Reena; Suwan, Yanin; Trivedi, Vivek; Krawitz, Brian; Mo, Shelley; Pinhas, Alexander; Tantraworasin, Apichat; Chui, Toco Y. P.; Ritch, Robert; Rosen, Richard B.

doi:10.1136/bjophthalmol-2016-309642

Cited by 111 publications

(105 citation statements)

References 28 publications

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“…A significant correlation was found between the OCTA parameters and visual field MD, between OCTA parameters and glaucoma stage, and, as previously described, between the OCTA and OCT parameters in the peripapillary area [6, 17-20, 22-24, 26, 28-30, 33, 35, 36, 38, 39, 41, 45, 48, 50, 71-75], the optic disc [19, 23, 29, 36, 51-53, 57, 58], and the macular area [21, 36, 38, 61, 62, 64, 69, 75, 76]. As mentioned above, the results for the parafoveal area were not significant in some of the studies [38, 70].…”

Section: Resultsmentioning

confidence: 87%

“…As mentioned above, the results for the parafoveal area were not significant in some of the studies [38, 70]. Vessel density defects (measured with OCTA) were spatially associated with OCT and visual field defects in the 3 above-mentioned regions [6, 17, 18, 20-24, 29, 30, 45, 48, 69, 72, 74, 76-78]. …”

Section: Resultsmentioning

confidence: 90%

“…Most studies found an AUC above 0.850 both for the OCTA parameters [17, 20, 22, 23, 25, 31, 32, 37, 41] and for the RNFL [19, 20, 22, 25, 31, 34, 37, 49]. Only 2 studies found a significant difference, with a better AUC for the RNFL [19, 34] in both cases.…”

Section: Resultsmentioning

confidence: 94%

“…The area under the curve (AUC) for the best discriminating OCTA parameter (vessel density and blood flow index) ranged between 0.75 and 1.00, while for the OCT parameter (RNFL) the values ranged between 0.76 and 0.97 [17, 19, 20, 22, 23, 25, 27, 31, 32, 34, 36, 37, 41, 49]. Most studies found an AUC above 0.850 both for the OCTA parameters [17, 20, 22, 23, 25, 31, 32, 37, 41] and for the RNFL [19, 20, 22, 25, 31, 34, 37, 49].…”

Section: Resultsmentioning

confidence: 99%

“…Most studies investigated the OCTA parameters in the superficial layers (above the inner plexiform layer) [3, 16, 18, 20-22, 25-29, 32-38, 41, 45, 47, 48, 50, 61-63, 69-71, 75-77, 85-88] or in the full-thickness scan [6, 17, 19, 21, 23, 30, 36, 39, 46, 51-54, 56-58, 62, 72, 83]. …”

Section: Resultsmentioning

confidence: 99%

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Optical Coherence Tomography Angiography in Glaucoma: A Review

et al. 2018

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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.

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Section: Resultsmentioning

confidence: 87%

Section: Resultsmentioning

confidence: 90%

Section: Resultsmentioning

confidence: 94%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Optical Coherence Tomography Angiography in Glaucoma: A Review

et al. 2018

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Quantitative Microvascular Analysis With Wide-Field Optical Coherence Tomography Angiography in Eyes With Diabetic Retinopathy

et al. 2020

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IMPORTANCE Wide-field optical coherence tomographic angiography (OCTA) may provide insights to peripheral capillary dropout in eyes with diabetic retinopathy (DR).OBJECTIVE To describe the diagnostic performance of wide-field OCTA with and without large vessel removal for assessment of DR in persons with diabetes. DESIGN, SETTING, AND PARTICIPANTSThis case-control study was performed from April 26, 2018, to April 8, 2019, at a single tertiary eye center in Singapore. Case patients were those with type 2 diabetes for more than 5 years and bilateral DR diagnosed by fundus imaging; control participants included those with no self-reported history of diabetes, a fasting glucose level within the normal range in the past year, and no ocular pathologic findings. A wide-field (12 × 12-mm 2 ) fovea-centered scan was performed using a prototype swept source OCTA system. Retinal microvasculature was examined by separating the angiograms into large vessels, capillaries, and capillary dropout regions. MAIN OUTCOMES AND MEASURES Area under the receiver operating characteristic curve (AUC)for DR severity discrimination using wide-field vascular metrics. Retinal perfusion density (RPD), capillary perfusion density (CPD), large vessel density (LVD), and capillary dropout density (CDD) were calculated. Low-contrast regions were excluded from the calculation. RESULTSA total of 49 eyes in 27 control participants (17 male [63.0%]; mean [SD] age, 59.96 [7.63] years; age range, 44-79 years) and 76 eyes in 47 patients with diabetes (29 male [61.7%]; mean [SD] age, 64.36 [8.08] years; range, 41-79 years) were included. Among eyes in patients with diabetes, 23 were in those with diabetes but no DR, 25 in those with mild nonproliferative DR, and 28 in those with moderate to severe nonproliferative DR. There was no difference in RPD, CPD, LVD, and CDD between the control group and the group with diabetes and no DR. There was a stepwise decrease in RPD, CPD, and CDD in the diabetes with no DR, mild nonproliferative DR, and moderate to severe nonproliferative DR groups, whereas LVD was not associated with DR staging. The nonproliferative DR group had decreased RPD, CPD, and CDD compared with the control group. The CPD had higher AUCs than RPD for discriminating diabetes with nonproliferative DR (combined mild and moderate to severe nonproliferative DR) vs no DM (AUC, 0.92 [95% CI, 0.87-0.98] vs 0.89 [95% CI, 0.83-0.95], P = .01), diabetes with no DR vs mild nonproliferative DR (AUC, 0.81 [95% CI, 0.68-0.94] vs 0.77 [95% CI, 0.64-0.91], P = .18), and mild nonproliferative DR vs moderate to severe nonproliferative DR (AUC, 0.82 [95% CI, 0.71-0.94] vs 0.78 [95% CI, 0.65-0.91], P = .01) but similar AUCs for no DM vs diabetes with no DR. The total perfusion density and CPD in wide-field OCTA had better discriminative power than the central 6 × 6-mm 2 field (CPD, 0.89 [95% CI, 0.83-0.95] vs 0.84 [95% CI, 0.77-0.92], P = .06; total perfusion density, 0.93 [95% CI, 0.87-0.98] vs 0.90 [95% CI, 0.83-0.96], P = .06).(continued) Key Points Question Wha...

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Association of Myopia With Peripapillary Perfused Capillary Density in Patients With Glaucoma

et al. 2018

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IMPORTANCE This study used optical coherence tomographic angiography to assess for impaired blood flow in myopic eyes with or without open-angle glaucoma. OBJECTIVE To compare the peripapillary perfused capillary density (PCD) between eyes with and without glaucoma. DESIGN, SETTING, AND PARTICIPANTS In this cross-sectional study at a tertiary glaucoma referral practice, we recruited patients with myopic eyes of spherical equivalent of more than −3.0 diopters with and without open-angle glaucoma, patients with nonmyopic eyes with glaucoma, and patients with no disease from February 2016 to October 2016. We obtained 4.5 × 4.5-mm optical coherence tomographic angiography images of the optic nerve head and calculated PCD as the ratio of pixels associated with capillaries to the number of pixels in the region of interest after large blood vessel removal. Both eyes of each patient were used in the analysis. Continuous variables were assessed by analysis of variance and Tukey tests. A marginal model of generalized estimating equations was performed to adjust for confounding factors and intraclass correlations. MAIN OUTCOMES AND MEASURES Mean PCD. RESULTS We matched 87 patients with myopic eyes with glaucoma (of whom 39 [45%] were women), 17 with myopic eyes without glaucoma (of whom 10 [59%] were women), and 93 with non-myopic eyes with glaucoma (of whom 55 [59%] were women) for visual field defects and included 51 control participants (or whom 38 [75%] were women). Mean (SD) ages were 67.5 (12.0) years for patients with myopia and glaucoma, 48.2 (19.0) years for those with myopia without glaucoma, 67.3 (11.0) years for those with glaucoma without myopia, and 64.7 (8.9) years in control participants. Global PCD demonstrated a progressive decrease from the control group (mean [SD], 41.0 [4.2]) to those with myopia without glaucoma (38.4 [5.8]) to those with glaucoma without myopia (31.9 [7.5]) to those with both (28.2 [6.0]; all P < .001). The mean difference in global PCD between the 3 groups and control group, adjusted for age and axial length, was greatest in those with myopia and glaucoma (−11.1; 95% CI, −14.0 to −8.1; P < .001), followed by those with glaucoma without myopia (−8.6; 95% CI, −10.9 to −6.3; P < .001) and those with myopia without glaucoma (−2.8; 95% CI, −6.9 to 1.2; P = .17). No interaction was found between glaucoma and myopia. CONCLUSIONS AND RELEVANCE These findings demonstrate peripapillary microvascular attenuation to a greater extent in open-angle glaucoma than myopia. The cross-sectional design means we cannot determine if this association is a cause and/or is associated with other confounding factors.

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Peripapillary perfused capillary density in primary open-angle glaucoma across disease stage:an optical coherence tomography angiography study

Cited by 111 publications

References 28 publications

Optical Coherence Tomography Angiography in Glaucoma: A Review

Optical Coherence Tomography Angiography in Glaucoma: A Review

Quantitative Microvascular Analysis With Wide-Field Optical Coherence Tomography Angiography in Eyes With Diabetic Retinopathy

Association of Myopia With Peripapillary Perfused Capillary Density in Patients With Glaucoma

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