1
|
Behera G, Kunnilethu R, Thirunavukarasu SC, Jayaraman R, Subramanyam T, Subramanian A. Comparing Intraocular Pressure, Ocular Blood Flow, and Retinal Nerve Fiber Layer Thickness in Early and Chronic Hypertensives With Normotensives. Curr Eye Res 2024; 49:631-638. [PMID: 38384233 DOI: 10.1080/02713683.2024.2319774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 02/12/2024] [Indexed: 02/23/2024]
Abstract
PURPOSE To compare blood pressure (BP), intraocular pressure (IOP), ophthalmic artery flow (OAF) velocity, retinal nerve fiber layer (RNFL) thickness, and visual fields in newly diagnosed hypertension (HT) patients (before treatment), chronic HT (on antihypertensive medications >5 years) and normotensives. METHODS A prospective, cross-sectional study at a tertiary care centre in India. Three groups of 45 patients each: group 1 - early HT, group 2 - chronic HT, and Group 3 - normotensives, underwent evaluation of BP, IOP by Goldmann applanation tonometry (GAT), OAF velocity by transcranial doppler (TCD), RNFL analysis by spectral-domain optical coherence tomography (SD-OCT), and visual fields. RESULTS The BP was highest in early HT > chronic HT > normotensives (p < 0.001). The IOP of early HT, chronic HT, and normotensives were 15.87 ± 2.19 mmHg, 13.47 ± 1.92 mmHg, and 15.67 ± SD 1.75 mmHg (p < 0.001). The OAF velocity [peak systolic velocity (PSV), end-diastolic velocity (EDV) in cm/sec] was lowest in chronic HT (30.80 ± 7.05, 8.58 ± 1.58) < early HT (35.47 ± 5.34, 10.02 ± 1.74) < normotensives (36.29 ± 4.43, 10.44 ± 2.29), (p < 0.001). The average RNFL thickness was significantly lower in chronic HT (p = 0.022). The PSV, EDV, and MFV showed significant correlation with IOP (r = 0.247, p = 0.004; r = 0.206, p = 0.016; r = 0.266, p = 0.002) and average RNFL thickness (r = 0.309, p= <0.001; r = 0.277, p = 0.001; r = 0.341, p < 0.001). CONCLUSIONS Patients with chronic HT demonstrated the lowest retrobulbar flows, IOP and lower RNFL measurements. Lower ocular perfusion may be associated with lower IOP and may be a risk factor for end-organ damage (RNFL) independent of IOP.
Collapse
Affiliation(s)
- Geeta Behera
- Department of Ophthalmology, Jawaharlal Institute of Post-Graduate Medical Education and Research (JIPMER), Puducherry, India
| | - Ritu Kunnilethu
- Department of Ophthalmology, Indira Gandhi Government General Hospital and Post Graduate Institute (IGGGH&PGI), Puducherry, India
| | | | - Ramesh Jayaraman
- Department of Internal Medicine, Indira Gandhi Government General Hospital and Post Graduate Institute (IGGGH&PGI), Puducherry, India
| | - Thanikachalam Subramanyam
- Department of Ophthalmology, Indira Gandhi Government General Hospital and Post Graduate Institute (IGGGH&PGI), Puducherry, India
| | - Anandaraja Subramanian
- Department of Cardiology, Indira Gandhi Government General Hospital and Post Graduate Institute (IGGGH&PGI), Puducherry, India
| |
Collapse
|
2
|
Tansuebchueasai N, Nishida T, Moghimi S, Wu JH, Mahmoudinezhad G, Gunasegaran G, Kamalipour A, Zangwill LM, Weinreb RN. Rate of Initial Optic Nerve Head Capillary Density Loss and Risk of Visual Field Progression. JAMA Ophthalmol 2024; 142:530-537. [PMID: 38696186 PMCID: PMC11066764 DOI: 10.1001/jamaophthalmol.2024.0906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 02/17/2024] [Indexed: 05/05/2024]
Abstract
Importance Rapid initial optic nerve head capillary density loss may be used to assess the risk of glaucoma visual field progression. Objective To investigate the association between the rate of initial optic nerve head capillary density loss from optical coherence tomography angiography (OCTA) and visual field progression. Design, Setting, Participants This was a retrospective study of a longitudinal cohort at a glaucoma referral center. A total of 167 eyes (96 with primary open-angle glaucoma and 71 with glaucoma suspect) of 109 patients were monitored for a mean (SD) of 5.7 (1.4) years from January 2015 to December 2022. Data analysis was undertaken in April 2023. Main Outcomes and Measures The rates of initial capillary density and average retinal nerve fiber layer loss were calculated from the first 3 optic nerve head OCTA and OCT scans, respectively, during the initial follow-up (mean [SD], 2.0 [1.0] years). Based on the median rate, eyes were categorized into fast and slow progressor groups. The association between initial capillary density change or retinal nerve fiber layer thinning and visual field progression was evaluated using linear-mixed and time-varying Cox models. Results A total of 167 eyes of 109 patients (mean [SD] age, 69.0 [11.1] years; 56 [51.4%] female and 53 [48.6%] male) were assessed. Eighty-three eyes were slow OCTA progressors, while 84 eyes were fast with mean capillary density loss of -0.45% per year and -1.17% per year, respectively (mean difference, -0.72%/year; 95% CI,-0.84 to -0.60; P < .001). Similarly, 83 eyes were slow OCT progressors, while 84 eyes were fast with mean retinal nerve fiber layer thinning of -0.09 μm per year and -0.60 μm per year, respectively (mean difference, -0.51 μm/year; 95% CI,-0.59 to -0.43; P < .001). The fast OCTA and OCT progressors were associated with more rapid visual field loss (mean difference, -0.18 dB/year; 95% CI,-0.30 to -0.06; P = .004 and -0.17 dB/year; 95% CI,-0.29 to -0.06; P = .002, respectively). Fast OCTA progressing eyes were more likely to have visual field progression (hazard ratio, 1.96; 95% CI, 1.04-3.69; P = .04). Seventeen of 52 eyes (32.7%; 95% CI, 32.5-32.8) with fast OCTA and OCT progression developed subsequent visual field likely progression. Conclusion and Relevance Rapid initial optic nerve head capillary density loss from OCTA was associated with a faster rate of visual field progression and a doubling of the risk of developing event progression in this study. These findings may support clinical use of OCTA and OCT optic nerve head measurements for risk assessment of glaucoma progression.
Collapse
Affiliation(s)
- Natchada Tansuebchueasai
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla
- Department of Ophthalmology, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Takashi Nishida
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla
| | - Sasan Moghimi
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla
| | - Jo-Hsuan Wu
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla
| | - Golnoush Mahmoudinezhad
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla
| | - Gopikasree Gunasegaran
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla
| | - Alireza Kamalipour
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla
| | - Linda M. Zangwill
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla
| | - Robert N. Weinreb
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla
| |
Collapse
|
3
|
Tsai YC, Lee HP, Tsung TH, Chen YH, Lu DW. Unveiling Novel Structural Biomarkers for the Diagnosis of Glaucoma. Biomedicines 2024; 12:1211. [PMID: 38927418 PMCID: PMC11200849 DOI: 10.3390/biomedicines12061211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 05/21/2024] [Accepted: 05/28/2024] [Indexed: 06/28/2024] Open
Abstract
Glaucoma, a leading cause of irreversible blindness, poses a significant global health burden. Early detection is crucial for effective management and prevention of vision loss. This study presents a collection of novel structural biomarkers in glaucoma diagnosis. By employing advanced imaging techniques and data analysis algorithms, we now can recognize indicators of glaucomatous progression. Many research studies have revealed a correlation between the structural changes in the eye or brain, particularly in the optic nerve head and retinal nerve fiber layer, and the progression of glaucoma. These biomarkers demonstrate value in distinguishing glaucomatous eyes from healthy ones, even in the early stages of the disease. By facilitating timely detection and monitoring, they hold the potential to mitigate vision impairment and improve patient outcomes. This study marks an advancement in the field of glaucoma, offering a promising avenue for enhancing the diagnosis and possible management.
Collapse
Affiliation(s)
- Yu-Chien Tsai
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
- Department of Ophthalmology, Taoyuan Armed Forces General Hospital, Taoyuan 325, Taiwan
| | - Hsin-Pei Lee
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
| | - Ta-Hsin Tsung
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
| | - Yi-Hao Chen
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
| | - Da-Wen Lu
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
| |
Collapse
|
4
|
Braun M, Saini C, Sun JA, Shen LQ. The Role of Optical Coherence Tomography Angiography in Glaucoma. Semin Ophthalmol 2024:1-12. [PMID: 38643350 DOI: 10.1080/08820538.2024.2343049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 04/09/2024] [Indexed: 04/22/2024]
Abstract
Glaucoma is the leading cause of irreversible vision loss and comprises a group of chronic optic neuropathies characterized by progressive retinal ganglion cell (RGC) loss. Various etiologies, including impaired blood supply to the optic nerve, have been implicated for glaucoma pathogenesis. Optical coherence tomography angiography (OCTA) is a non-invasive imaging modality for visualizing the ophthalmic microvasculature. Using blood flow as an intrinsic contrast agent, it distinguishes blood vessels from the surrounding tissue. Vessel density (VD) is mainly used as a metric for quantifying the ophthalmic microvasculature. The key anatomic regions for OCTA in glaucoma are the optic nerve head area including the peripapillary region, and the macular region. Specifically, VD of the superficial peripapillary and superficial macular microvasculature is reduced in glaucoma patients compared to unaffected subjects, and VD correlates with functional deficits measured by visual field (VF). This renders OCTA similar in diagnostic capabilities compared to structural retinal nerve fiber layer (RNFL) thickness measurements, especially in early glaucoma. Furthermore, in cases where RNFL thickness measurements are limited due to artifact or floor effect, OCTA technology can be used to evaluate and monitor glaucoma, such as in eyes with high myopia and eyes with advanced glaucoma. However, the clinical utility of OCTA in glaucoma management is limited due to the prevalence of imaging artifacts. Overall, OCTA can play a complementary role in structural OCT imaging and VF testing to aid in the diagnosis and monitoring of glaucoma.
Collapse
Affiliation(s)
- Maximilian Braun
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Chhavi Saini
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Jessica A Sun
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Lucy Q Shen
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| |
Collapse
|
5
|
Leclaire MD, Storp JJ, Lahme L, Esser EL, Eter N, Alnawaiseh M. Reduced Retinal Blood Vessel Densities Measured by Optical Coherence Tomography Angiography in Keratoconus Patients Are Negatively Correlated with Keratoconus Severity. Diagnostics (Basel) 2024; 14:707. [PMID: 38611620 PMCID: PMC11011292 DOI: 10.3390/diagnostics14070707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Revised: 03/15/2024] [Accepted: 03/25/2024] [Indexed: 04/14/2024] Open
Abstract
Keratoconus (KC) is the most common corneal ectasia. Optical coherence tomography angiography (OCT-A) is a relatively new non-invasive imaging technique that allows the visualization and quantification of retinal and choriocapillary blood vessels. The aim of this study is to assess retinal and choriocapillary vessel density (VD) differences between KC patients and healthy controls and to investigate correlations between VD and KC severity. Fifty-two eyes were included in this exploratory study: twenty-six eyes from 26 KC patients and twenty-six eyes from 26 age- and gender-matched healthy controls. All patients underwent Scheimpflug corneal topography with Pentacam, axis lengths measurement and optical coherence tomography angiography (OCT-A). The thinnest spot in corneal pachymetry, maximum K (Kmax) and KC severity indices from the Belin/Ambrósio enhanced ectasia display (BAD) were also assessed. There was a distinct reduction particularly in the retinal VD of the superficial capillary plexus (SCP). Correlation analyses showed strong and moderate negative correlations between the VD in the macular SCP and BAD KC scores and between the SCP VD and Kmax. There was no difference in retinal thickness between the KC and healthy controls. With this study, further evidence for altered VD measurements by OCT-A in KC patients is given. For the first time, we demonstrated negative correlations between BAD KC scores and retinal blood vessel alterations. A major limitation of the study is the relatively small sample size. Since an artefactual reduction of the quantitative OCT-A measurements due to irregular corneal topography in KC must be assumed, it remains to be investigated whether there are also actual changes in the retinal microcirculation in KC.
Collapse
Affiliation(s)
- Martin Dominik Leclaire
- Department of Ophthalmology, University Medical Center Münster, 48149 Münster, Germany; (J.J.S.); (E.L.E.); (N.E.)
| | - Jens Julian Storp
- Department of Ophthalmology, University Medical Center Münster, 48149 Münster, Germany; (J.J.S.); (E.L.E.); (N.E.)
| | - Larissa Lahme
- Department of Ophthalmology, University Medical Center Münster, 48149 Münster, Germany; (J.J.S.); (E.L.E.); (N.E.)
| | - Eliane Luisa Esser
- Department of Ophthalmology, University Medical Center Münster, 48149 Münster, Germany; (J.J.S.); (E.L.E.); (N.E.)
| | - Nicole Eter
- Department of Ophthalmology, University Medical Center Münster, 48149 Münster, Germany; (J.J.S.); (E.L.E.); (N.E.)
| | - Maged Alnawaiseh
- Department of Ophthalmology, Klinikum Bielefeld gem. GmbH, 33647 Bielefeld, Germany
| |
Collapse
|
6
|
Chen DF, Wang C, Si Y, Lu X, Zhou W, Huang Q, Zuo J, Cheng G, Leung DYL, Wang N, Friedman DS, Liang Y. Natural History and Risk Factors for Glaucoma Progression in Chinese Patients With Normal-Tension Glaucoma. Invest Ophthalmol Vis Sci 2024; 65:28. [PMID: 38506850 PMCID: PMC10959195 DOI: 10.1167/iovs.65.3.28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 02/27/2024] [Indexed: 03/21/2024] Open
Abstract
Purpose To characterize the natural history of normal-tension glaucoma (NTG) in Chinese patients. Methods The prospective observational cohort study included patients with untreated NTG with a minimum follow-up of 2 years. Functional progression was defined by visual field (VF) deterioration, while structural progression was characterized by thinning of the retinal nerve fiber layer (RNFL) or ganglion cell inner plexiform layer (GCIPL). Results Among 84 participants (mean age, 60.5 years; mean deviation, -5.01 decibels [dB]) with newly diagnosed NTG followed for an average of 69.7 months, 63.1% progressed during the observation period. Specifically, 29.8% progressed by VF, and 48.8% progressed by either RNFL or GCIPL. In Cox proportional hazards analysis, disc hemorrhage (hazard ratio [HR], 2.82; 95% confidence interval [CI], 1.48-5.35), female gender (HR, 1.98; 95% CI, 1.08-3.62), and mean IOP during the follow-up period (HR, 1.14 per mm Hg; 95% CI, 1.00-1.31) were significant predictors of glaucomatous progression. Additionally, longer axial length (AL; HR, 0.57 per millimeter; 95% CI, 0.35-0.94) was protective against VF progression faster than -0.50 dB/y, and higher minimum diastolic blood pressure (DBP; HR, 0.96 per mm Hg; 95% CI, 0.92-1.00) was protective against structural progression. Conclusions Nearly two-thirds of untreated Chinese patients with NTG progressed over an average follow-up of 70 months by VF, RNFL, or GCIPL. Disc hemorrhage, female gender, higher mean IOP, shorter AL, and lower minimum DBP were significant predictors for disease progression.
Collapse
Affiliation(s)
- De-Fu Chen
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- Glaucoma Research Institute, Wenzhou Medical University, Wenzhou, China
| | - Chenmin Wang
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- Glaucoma Research Institute, Wenzhou Medical University, Wenzhou, China
| | - Yuqing Si
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- Glaucoma Research Institute, Wenzhou Medical University, Wenzhou, China
| | - Xiaonan Lu
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- Glaucoma Research Institute, Wenzhou Medical University, Wenzhou, China
| | - Weihe Zhou
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Qiangjie Huang
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Jingjing Zuo
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- Glaucoma Research Institute, Wenzhou Medical University, Wenzhou, China
| | - Gangwei Cheng
- Key Laboratory of Ocular Fundus Diseases, Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Dexter Y. L. Leung
- Department of Ophthalmology, Hong Kong Sanatorium and Hospital, Hong Kong SAR, China
| | - Ningli Wang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Science Key Lab, Beijing, China
| | - David S. Friedman
- Glaucoma Center of Excellence, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, United States
| | - Yuanbo Liang
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- Glaucoma Research Institute, Wenzhou Medical University, Wenzhou, China
| |
Collapse
|
7
|
Gunasegaran G, Moghimi S, Nishida T, Walker E, Kamalipour A, Wu JH, Mahmoudinezhad G, Zangwill LM, Weinreb RN. Racial Differences in the Diagnostic Accuracy of OCT Angiography Macular Vessel Density for Glaucoma. Ophthalmol Glaucoma 2024; 7:197-205. [PMID: 37783272 DOI: 10.1016/j.ogla.2023.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 08/29/2023] [Accepted: 09/21/2023] [Indexed: 10/04/2023]
Abstract
PURPOSE To evaluate and compare the diagnostic accuracy of macular vessel density (VD) measured by OCT angiography (OCTA) in individuals of African descent (AD) and European descent (ED) with open-angle glaucoma. DESIGN Observational, cross sectional study. PARTICIPANTS A total of 176 eyes of 123 patients with glaucoma and 140 eyes of 88 healthy participants from the Diagnostic Innovations in Glaucoma Study. METHODS Whole-image ganglion cell complex (wiGCC) thickness and macular VD (parafoveal VD and perifoveal VD) were obtained from 6 × 6 macula scans. Area under the receiver operating characteristic (AUROC) curves were used to evaluate the diagnostic accuracy of macular VD and ganglion cell complex (GCC) thickness in AD and ED participants after adjusting for confounders such as age, visual field mean deviation (VF MD), signal strength index, axial length, self-reported hypertension and diabetes. MAIN OUTCOME MEASURES Macular VD and wiGCC measurements. RESULTS Parafoveal and perifoveal VD were significantly lower in ED than AD patients with glaucoma. Parafoveal and perifoveal VD performed significantly worse in AD participants compared with ED participants for detection of glaucoma (adjusted AUROC, 0.75 [95% confidence interval (CI), 0.62, 0.87], 0.85 [95% CI, 0.79, 0.90], P = 0.035; and 0.82 [95% CI, 0.70, 0.92], 0.91 [95% CI, 0.87, 0.94], respectively; P = 0.020). In contrast to VD, diagnostic accuracy of GCC thickness was similar in AD and ED individuals (adjusted AUROC, 0.89 [95% CI, 0.79, 0.96], 0.92 [95% CI, 0.86, 0.96], respectively; P = 0.313). The diagnostic accuracies of both macular VD and GCC thickness for differentiating between glaucoma and healthy eyes increased with increasing VF MD in both AD and ED participants. CONCLUSIONS Diagnostic performance of OCTA macular VD, but not GCC thickness, for glaucoma detection varies by race. Moreover, macular VD parameters had lower accuracy for detecting glaucoma in AD individuals than in ED individuals. The diagnostic performance of macular VD is race-dependent, and, therefore, race should be taken into consideration when interpreting macular OCTA results. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
Collapse
Affiliation(s)
- Gopikasree Gunasegaran
- Viterbi Family Department of Ophthalmology, Hamilton Glaucoma Center, Shiley Eye Institute, University of California San Diego, La Jolla, California
| | - Sasan Moghimi
- Viterbi Family Department of Ophthalmology, Hamilton Glaucoma Center, Shiley Eye Institute, University of California San Diego, La Jolla, California
| | - Takashi Nishida
- Viterbi Family Department of Ophthalmology, Hamilton Glaucoma Center, Shiley Eye Institute, University of California San Diego, La Jolla, California
| | - Evan Walker
- Viterbi Family Department of Ophthalmology, Hamilton Glaucoma Center, Shiley Eye Institute, University of California San Diego, La Jolla, California
| | - Alireza Kamalipour
- Viterbi Family Department of Ophthalmology, Hamilton Glaucoma Center, Shiley Eye Institute, University of California San Diego, La Jolla, California
| | - Jo-Hsuan Wu
- Viterbi Family Department of Ophthalmology, Hamilton Glaucoma Center, Shiley Eye Institute, University of California San Diego, La Jolla, California
| | - Golnoush Mahmoudinezhad
- Viterbi Family Department of Ophthalmology, Hamilton Glaucoma Center, Shiley Eye Institute, University of California San Diego, La Jolla, California
| | - Linda M Zangwill
- Viterbi Family Department of Ophthalmology, Hamilton Glaucoma Center, Shiley Eye Institute, University of California San Diego, La Jolla, California
| | - Robert N Weinreb
- Viterbi Family Department of Ophthalmology, Hamilton Glaucoma Center, Shiley Eye Institute, University of California San Diego, La Jolla, California.
| |
Collapse
|
8
|
Saks DG, Schulz A, Qassim A, Marshall H, Hewitt AW, MacGregor S, Craig JE, Graham SL. Genetic risk of glaucoma is associated with vascular and retinal nerve fibre wedge defects. Acta Ophthalmol 2024; 102:e185-e194. [PMID: 37800621 DOI: 10.1111/aos.15775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 08/31/2023] [Accepted: 09/18/2023] [Indexed: 10/07/2023]
Abstract
PURPOSE To evaluate the association between localised vascular and retinal nerve fibre layer (RNFL) loss and genetic risk for glaucoma and cardiovascular disease using polygenic risk scores (PRS). METHODS 858 eyes were included from 455 individuals with suspect and early manifest primary open angle glaucoma. Eyes were characterised as having localised vascular and/or RNFL wedge-shaped defects by scrutiny of optical coherence tomography angiography (OCTA) and OCT images, respectively. Investigations included associations with pre-established scores for genetic risk of glaucoma and cardiovascular disease in the context of glaucoma risk factors and systemic vascular disease outcomes. RESULTS Higher genetic risk for glaucoma was associated with both vascular wedge defects and RNFL defects (p < 0.001 and p = 0.020, respectively). A greater genetic risk of glaucoma was associated with the presence of multiple vascular wedges per eye (p = 0.005). Glaucoma progression based on global RNFL loss was associated with vascular and RNFL wedge defects (p ≤ 0.001 and p = 0.008, respectively). The glaucoma PRS was significantly associated with vascular, but not RNFL, wedge defects after controlling for disc haemorrhage (p = 0.007 and p = 0.070, respectively). Vascular wedge defects were not related to the cardiovascular PRS. CONCLUSION Individuals with a higher genetic risk of glaucoma based on the PRS were more likely to have retinal vascular defects, as well as structural glaucomatous loss, but this did not relate to systemic cardiovascular risk. This possibly implies a local pathophysiology for the vascular defects in some cases, which may have clinical relevance in the early stages of glaucoma and in individuals at high genetic risk.
Collapse
Affiliation(s)
- Danit G Saks
- Macquarie Medical School, Macquarie University, Sydney, New South Wale, Australia
| | - Angela Schulz
- Macquarie Medical School, Macquarie University, Sydney, New South Wale, Australia
| | - Ayub Qassim
- Flinders Medical Centre, Flinders University, Adelaide, South Australia, Australia
| | - Henry Marshall
- Flinders Medical Centre, Flinders University, Adelaide, South Australia, Australia
| | - Alex W Hewitt
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Stuart MacGregor
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Jamie E Craig
- Flinders Medical Centre, Flinders University, Adelaide, South Australia, Australia
| | - Stuart L Graham
- Macquarie Medical School, Macquarie University, Sydney, New South Wale, Australia
| |
Collapse
|
9
|
Mahmoudinezhad G, Moghimi S, Nishida T, Micheletti E, Du KH, Mohammadzadeh V, Wu JH, Kamalipour A, Weinreb RN. Intraocular pressure increases the rate of macular vessel density loss in glaucoma. Br J Ophthalmol 2024; 108:181-187. [PMID: 36535749 PMCID: PMC10277316 DOI: 10.1136/bjo-2022-322261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 11/30/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND/AIMS To evaluate the relationship over time between intraocular pressure (IOP) and the rate of macula whole image vessel density (wiVD) loss and whole image ganglion cell complex (wiGCC) thinning in glaucoma METHODS: From 62 patients in the Diagnostic Innovations in Glaucoma Study, 59 Primary open-angle glaucoma and 27 glaucoma suspect eyes with mean follow-up of 3.2 years were followed. Optical coherence tomography angiography (OCT-A)-based vessel density and OCT-based structural thickness of the same 6×6 mm GCC scan slab were evaluated. Univariable and multivariable linear mixed models were performed for all eyes and also a subset of them in which peak IOP <18 mm Hg to investigate the effect of IOP parameters on the rate of wiVD and wiGCC change. RESULTS The mean baseline visual field mean deviation (95% CI) was -3.3 dB (-4.4 to -2.1). Higher mean IOP (-0.07%/year per 1 mm Hg (-0.14 to -0.01), p=0.033), peak IOP (-0.07%/year per 1 mm Hg (-0.13 to -0.02), p=0.004) and IOP fluctuation (IOP SD) (-0.17%/year per 1 mm Hg (-0.32 to 0.02), p=0.026) were associated with faster macular vessel density loss. Faster wiGCC thinning was associated with higher mean IOP (-0.05 µm/year per 1 mm Hg (-0.10 to -0.01), p=0.015), peak IOP (-0.05 µm/year per 1 mm Hg (-0.08 to -0.02), p=0.003) and IOP fluctuation (-0.12 µm/year per 1 mm Hg (-0.22 to -0.01), p=0.032). In eyes with peak <18 mm Hg, faster wiVD progression was associated with higher mean IOP (p=0.042). Faster wiGCC progression was associated with higher mean IOP in these eyes (p=0.025). CONCLUSION IOP metrics were associated with faster rates of overall macular microvascular loss and also in the eyes with peak IOP <18 mm Hg. Future studies are needed to examine whether additional IOP lowering reduces the rate of microvascular loss in patients with glaucoma. TRIAL REGISTRATION NUMBER NCT00221897.
Collapse
Affiliation(s)
- Golnoush Mahmoudinezhad
- Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
| | - Sasan Moghimi
- Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
| | - Takashi Nishida
- Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
| | - Eleonora Micheletti
- Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
- Department of Surgical & Clinical, Diagnostic and Pediatric Sciences, Section of Ophthalmology-IRCCS Fondazione Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Kelvin H Du
- Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
| | - Vahid Mohammadzadeh
- Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
| | - Jo-Hsuan Wu
- Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
| | - Alireza Kamalipour
- Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
| | - Robert N Weinreb
- Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
| |
Collapse
|
10
|
Diane S, Okada N, Nikaido T, Kiuchi Y. Dissociation of retinal ganglion cell complex and superficial retinal vessel density on optical coherence tomography in a case of pediatric optic neuritis. Am J Ophthalmol Case Rep 2023; 32:101937. [PMID: 37860669 PMCID: PMC10582274 DOI: 10.1016/j.ajoc.2023.101937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 09/25/2023] [Accepted: 10/01/2023] [Indexed: 10/21/2023] Open
Abstract
Purpose To report the case of a pediatric patient with optic neuritis in whom changes in the retinal ganglion cell complex (GCC) and superficial retinal vessel density were dissociated. Observations An 8-year-old girl had an upper respiratory tract infection in early February 2019, after which she began to experience oculomotor pain and vision loss in her left eye. She was diagnosed with optic neuritis of the left eye. Initial examination showed a visual acuity of 20/20 in her right eye and light perception in her left eye. After steroid pulse therapy, her left visual acuity improved to 20/20 in April 2019, with no further symptoms to date. The GCC in the affected eye continued to become thinner until November 2019. However, optical coherence tomography angiography carried out after improvement in her visual function showed no difference in vascular density of the superficial retinal capillary plexus between the right and left eyes. Conclusions and importance In glaucoma, GCC thinning and vascular density loss occur almost simultaneously at an early stage. However, the current neuritis case showed changes in GCC but no corresponding changes in vascular density in the same area. This report suggests that optic neuritis and glaucoma involve different mechanisms of GCC thinning.
Collapse
Affiliation(s)
- Sonassa Diane
- Department of Ophthalmology and Visual Science, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima City, Hiroshima, 734-8551, Japan
- Faculty of Health Sciences and Technology, Gamal Abdel Nasser University, B.P. 1147, Conakry, Equatorial Guinea
| | - Naoki Okada
- Department of Ophthalmology and Visual Science, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima City, Hiroshima, 734-8551, Japan
| | - Takafumi Nikaido
- Department of Ophthalmology and Visual Science, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima City, Hiroshima, 734-8551, Japan
| | - Yoshiaki Kiuchi
- Department of Ophthalmology and Visual Science, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima City, Hiroshima, 734-8551, Japan
| |
Collapse
|
11
|
Verticchio Vercellin A, Siesky B, Antman G, Oddone F, Chang M, Eckert G, Arciero J, Kellner RL, Fry B, Coleman-Belin J, Carnevale C, Harris A. Regional Vessel Density Reduction in the Macula and Optic Nerve Head of Patients With Pre-Perimetric Primary Open Angle Glaucoma. J Glaucoma 2023; 32:930-941. [PMID: 37725789 PMCID: PMC10841039 DOI: 10.1097/ijg.0000000000002310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 09/04/2023] [Indexed: 09/21/2023]
Abstract
PRCIS Capillary and neuronal tissue loss occur both globally and with regional specificity in pre-perimetric glaucoma patients at the level of the optic nerve and macula, with perifovea regions affected earlier than parafovea areas. PURPOSE To investigate optic nerve head (ONH) and macular vessel densities (VD) and structural parameters assessed by optical coherence tomography angiography in pre-perimetric open angle glaucoma (ppOAG) patients and healthy controls. MATERIALS AND METHODS In all, 113 healthy and 79 ppOAG patients underwent global and regional (hemispheric/quadrants) assessments of retinal, ONH, and macular vascularity and structure, including ONH parameters, retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) thickness. Comparisons between outcomes in ppOAG and controls were adjusted for age, sex, race, BMI, diabetes, and hypertension, with P <0.05 considered statistically significant. RESULTS In ppOAG compared with healthy controls: RNFL thicknesses were statistically significantly lower for all hemispheres, quadrants, and sectors ( P <0.001-0.041); whole image peripapillary all and small blood vessels VD were statistically significantly lower for all the quadrants ( P <0.001-0.002), except for the peripapillary small vessels in the temporal quadrant (ppOAG: 49.66 (8.40), healthy: 53.45 (4.04); P =0.843); GCC and inner and full macular thicknesses in the parafoveal and perifoveal regions were significantly lower in all the quadrants ( P =0.000- P =0.033); several macular VD were significantly lower ( P =0.006-0.034), with the exceptions of macular center, parafoveal superior and inferior quadrant, and perifoveal superior quadrant ( P >0.05). CONCLUSIONS In ppOAG patients, VD biomarkers in both the macula and ONH, alongside RNFL, GCC, and macular thickness, were significantly reduced before detectable visual field loss with regional specificity. The most significant VD reduction detected was in the peripheric (perifovea) regions. Macular and ONH decrease in VD may serve as early biomarkers of glaucomatous disease.
Collapse
Affiliation(s)
| | - Brent Siesky
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Gal Antman
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Rabin Medical Center, Petah Tikva, Israel
| | | | - Michael Chang
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - George Eckert
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Julia Arciero
- Department of Mathematical Sciences, Indiana University Purdue University Indianapolis, Indianapolis, IN, United States
| | | | - Brendan Fry
- Department of Mathematics and Statistics, Metropolitan State University of Denver, Denver, CO, United States
| | | | | | - Alon Harris
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| |
Collapse
|
12
|
Liu K, You QS, Chen A, Choi D, White E, Chan JCH, Choy BNK, Shih KC, Wong JKW, Ng ALK, Cheung JJC, Ni MY, Lai JSM, Leung GM, Wong IYH, Huang D, Tan O. Sector-Based Regression Strategies to Reduce Refractive Error-Associated Glaucoma Diagnostic Bias When Using OCT and OCT Angiography. Transl Vis Sci Technol 2023; 12:10. [PMID: 37713187 PMCID: PMC10506684 DOI: 10.1167/tvst.12.9.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 08/03/2023] [Indexed: 09/16/2023] Open
Abstract
Purpose This cross-sectional study aimed to investigate the sectoral variance of optical coherence tomography (OCT) and OCT angiography (OCTA) glaucoma diagnostic parameters across eyes with varying degrees of refractive error. Methods Healthy participants, including individuals with axial ametropia, enrolled in the Hong Kong FAMILY cohort were imaged using the Avanti/AngioVue OCT/OCTA system. The OCT and OCTA parameters obtained include peripapillary nerve fiber layer thickness (NFLT), peripapillary nerve fiber layer plexus capillary density (NFLP-CD), and macular ganglion cell complex thickness (GCCT). Sectoral measurements of NFLT, NFLP-CD, and GCCT were based on sectors and hemispheres. Results A total of 1339 eyes from 791 participants were stratified based on spherical equivalent refraction: high myopia (<-6 D), low myopia (-6 D to -1 D), emmetropia (-1 D to 1 D), and hyperopia (>1 D). Multivariable broken stick regression models, accounting for age, sex, and signal strength, showed that all NFLT sectors except temporally, the inferior GCCT hemisphere, and half of the NFLP-CD sectors were more affected by ametropia-related covariates than the corresponding global parameters. As expected, the false-positive rates in those sectors were elevated. Finally, sector-specific axial length (AL) and spherical equivalent (SE) adjustments helped reduce the elevated false-positive rates. Conclusions The effect of optical magnification is even more prominent among sectors than the global parameters. AL- and SE-based adjustments should be individualized to each sector to mitigate this magnification bias effectively. Translational Relevance Identifying sectoral differences among diagnostic parameters and adopting these sector-based adjustments into commercial OCT systems will hopefully reduce false-positive rates related to refractive error.
Collapse
Affiliation(s)
- Keke Liu
- Casey Eye Institute, Oregon Health & Science University, Portland, OR, USA
- Department of Ophthalmology, Duke University School of Medicine, Durham, NC, USA
| | - Qi Sheng You
- Casey Eye Institute, Oregon Health & Science University, Portland, OR, USA
| | - Aiyin Chen
- Casey Eye Institute, Oregon Health & Science University, Portland, OR, USA
| | - Dongseok Choi
- Casey Eye Institute, Oregon Health & Science University, Portland, OR, USA
| | - Elizabeth White
- Casey Eye Institute, Oregon Health & Science University, Portland, OR, USA
| | - Jonathan C. H. Chan
- Department of Ophthalmology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Bonnie N. K. Choy
- Department of Ophthalmology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Kendrick C. Shih
- Department of Ophthalmology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Jasper K. W. Wong
- Department of Ophthalmology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Alex L. K. Ng
- Department of Ophthalmology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Janice J. C. Cheung
- Department of Ophthalmology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Michael Y. Ni
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong
- Healthy High Density Cities Lab, HKUrbanLab, The University of Hong Kong, Hong Kong
| | - Jimmy S. M. Lai
- Department of Ophthalmology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Gabriel M. Leung
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Ian Y. H. Wong
- Department of Ophthalmology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
- Department of Ophthalmology, Hong Kong Sanatorium & Hospital, Hong Kong
| | - David Huang
- Casey Eye Institute, Oregon Health & Science University, Portland, OR, USA
| | - Ou Tan
- Casey Eye Institute, Oregon Health & Science University, Portland, OR, USA
| |
Collapse
|
13
|
Lee EJ, Han JC, Kee C, Park KA, Kong DS, Hong SD. Peripapillary Vascular Density in Compressive Optic Neuropathy and Normal-Tension Glaucoma: A Severity-Controlled Comparison. Invest Ophthalmol Vis Sci 2023; 64:10. [PMID: 37672287 PMCID: PMC10484018 DOI: 10.1167/iovs.64.12.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 08/03/2023] [Indexed: 09/07/2023] Open
Abstract
Purpose To investigate the differences in peripapillary vessel density (VD) between compressive optic neuropathy (CON) and normal-tension glaucoma (NTG). Methods We compared patients with chronic CON and NTG, particularly after strictly controlling the mean extent of macular damage by the area of the ganglion cell-inner plexiform layer (GCIPL) loss in optical coherence tomography (OCT). We compared retinal nerve fiber layer (RNFL) and GCIPL thickness from OCT and peripapillary and macular VD from OCT angiography (OCTA) between the CON and NTG groups. Results From the initial 184 patients with CON and 443 patients with OAG, we included 41 patients with CON (57 eyes) and 64 patients with NTG (75 eyes) with a comparable extent of macular GCIPL thinning. Under similar mean macular involvement, the peripapillary VD was significantly lower in the CON group than in the NTG group after considering the effects of age, spherical equivalent, visual field sensitivity, peripapillary RNFL (pRNFL) thickness, GCIPL thickness, and image quality scores (P < 0.001). Marked loss of VD in the temporal and nasal sectors in CON was notable, attributing to the significantly lower peripapillary VD compared to NTG. Conclusions Patients with CON had a significantly lower peripapillary VD than those with NTG under similar mean degrees of pRNFL thickness and GCIPL damage. Our results reveal the potential utility of OCTA VD besides OCT pRNFL thickness, in relation to different topographic patterns of pRNFL loss, and possible differences in the pathogenesis of microvascular compromise between CON and NTG.
Collapse
Affiliation(s)
- Eun Jung Lee
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jong Chul Han
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Changwon Kee
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyung-Ah Park
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Doo-Sik Kong
- Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sang Duk Hong
- Department of Otolaryngology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| |
Collapse
|
14
|
Hwang HS, Lee EJ, Kim H, Kim TW. Relationships of Macular Functional Impairment With Structural and Vascular Changes According to Glaucoma Severity. Invest Ophthalmol Vis Sci 2023; 64:5. [PMID: 37669065 PMCID: PMC10484033 DOI: 10.1167/iovs.64.12.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 08/09/2023] [Indexed: 09/06/2023] Open
Abstract
Purpose To determine the pointwise relationships of central visual field (VF) defects with macular ganglion cell loss and macular vessel density (VD) loss during various stages of glaucoma. Methods Eyes with primary open-angle glaucoma (POAG) were subjected to optical coherence tomography (OCT) and OCT angiography (OCTA) to evaluate macular ganglion cell layer (GCL) thickness and macular VD in the superficial and deep vascular complexes (SVC and DVC). OCT, OCTA, and VF locations were matched after correcting for retinal ganglion cell (RGC) displacement. Pointwise correlations of GCL thickness and VDs of the SVC and DVC with central VF sensitivity (VFS) were evaluated by Pearson's correlation analysis and compared in eyes with early and advanced POAG by Meng's test. Results Of the 100 eyes, 52 and 48 were classified as early and advanced POAG. Macular VD showed overall better correlation with central VFS than GCL thickness in both the early and advanced groups. SVC density showed the strongest correlation with central VFS in all groups (R = 0.327 in early group, R = 0.325 in advanced group, all P < 0.001). Although DVC density showed better correlation with VFS (R = 0.311) than GCL thickness (R = 0.212) in the early group (P < 0.001), the correlation was comparable in the advanced group (R = 0.199 and 0.176, respectively, P = 0.254). Conclusions After adjustment for RGC displacement, macular SVC density was better correlated with central VFS than macular GCL thickness in both early and advanced POAG. Macular DVC density showed better correlation with VFS than GCL thickness in early but not in advanced POAG, indicating that DVC loss may be involved in early central VF loss.
Collapse
Affiliation(s)
- Hye Seong Hwang
- Department of Ophthalmology, Chungbuk National University College of Medicine, Chungbuk National University Hospital, Choengju, Korea
| | - Eun Ji Lee
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Hyunjoong Kim
- Department of Applied Statistics, Yonsei University, Seoul, Korea
| | - Tae-Woo Kim
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| |
Collapse
|
15
|
AM S, Anany M, Awwad MA, Sanad E, Eltohamy SMM. The Effect of Myopia on Vessel Density in Glaucomatous Patients by Optical Coherence Tomography Angiography. Clin Ophthalmol 2023; 17:2429-2441. [PMID: 37609643 PMCID: PMC10441653 DOI: 10.2147/opth.s418194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 06/27/2023] [Indexed: 08/24/2023] Open
Abstract
Background Glaucoma is a degenerative optic neuropathy that causes anatomical and functional visual impairment. Aim and Objectives This investigation's primary goal was to perform a qualitative and quantitative assessment of macular and peripapillary vessels to detect the impairment of blood flow in glaucomatous patients with or without myopia which can affect the prognosis of glaucoma and visual field. Subjects and Methods This prospective, cross-sectional, observational research was performed for glaucomatous patients with and without myopia who attend the outpatient clinic at the ophthalmology department, at Benha University. The study was conducted on 50 subjects with glaucomatous eyes, divided into two groups: the first group consisted of (25 subjects) of glaucoma with myopia and the second group (25 subjects) of glaucoma with the same severity of mean deviation in the visual field of group 1 without myopia, using OCTA to measure retinal vessel density (superficial vessel density) and OCT thickness ILM-RPE, RNFL thickness, GCL and small vessel density (RADIAL PERI PAPILLARY PLEXUS). Results Regarding demographic data of myopia in the studied eyes, there were (9) 18% with low myopia with no significance, (32) 64% with moderate myopia, and (9) 18% with high myopia, with open-angle glaucoma patients showed a highly significant decline in total retinal nerve fiber layer thickness, superior-nasal RNFL thickness, Inferior-nasal RNFL thickness, superior-temporal RNFL and inferior-temporal RNFL thickness compared to open-angle glaucoma patients without myopia. Conclusion Our results show that microvascular attenuation occurs more significantly in OAG than in myopia. When both myopia and OAG are present, there is a higher reduction in microvascular attenuation than with either disease alone. The development and progression of glaucoma in individuals with high myopia are more aggressive than in low or non-myopia, so by using OCTA detection of early microvascular changes in high myopia, individuals help the early detection and management of glaucoma.
Collapse
Affiliation(s)
- Saeed AM
- Department of Ophthalmology, Benha University Hospital, Benha, Qualubia, Egypt
| | - Mohamed Anany
- Department of Ophthalmology, Benha University Hospital, Benha, Qualubia, Egypt
| | - Mohamed A Awwad
- Department of Ophthalmology, Benha University Hospital, Benha, Qualubia, Egypt
| | - Eman Sanad
- Department of Ophthalmology, Benha University Hospital, Benha, Qualubia, Egypt
| | - Soha M M Eltohamy
- Department of Ophthalmology, Benha University Hospital, Benha, Qualubia, Egypt
| |
Collapse
|
16
|
Łukasik U, Wróbel-Dudzińska D, Jarecki J, Gasińska K, Żarnowski T, Święch A, Kosior-Jarecka E. The Differences in the Pattern of OCT and OCTA Examinations between Early Normal- and High-Tension Pseudoexfoliative Glaucoma. J Clin Med 2023; 12:4899. [PMID: 37568302 PMCID: PMC10419536 DOI: 10.3390/jcm12154899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 07/10/2023] [Accepted: 07/21/2023] [Indexed: 08/13/2023] Open
Abstract
Purpose. The aim of this study was to compare the results of optical coherence tomography angiography (OCTA) and optical coherence tomography (OCT) examinations in patients with normal-tension glaucoma (NTG) in comparison to high-tension pseudoexfoliative glaucoma (HTG) patients at the early stage of glaucoma. Material and methods. The studied groups consisted of patients in the early stage of NTG (70 eyes) and the early stage of HTG (71 eyes). In NTG and HTG groups, a detailed ophthalmic examination was performed. Optic disc OCT with peripapillary RNFL measurements and OCTA examination with the evaluation of the macula and optic disc were performed for all participants using Zeiss Cirrus 5000. Results. NTG and HTG groups were statistically similar as far as the MD was concerned, and both groups had early glaucoma. When evaluating the RNFL thickness, the only statistical difference between early NTG and HTG was observed in the thicknesses in the temporal sector of peripapillary RNFL, with thinner values in the NTG group (53.94 vs. 59.94, p = 0.0071). When the OCTA results of the macula and optic disc were evaluated, there were no statistical differences between early NTG and HTG. Conclusions. The vascular density and flow parameters assessed in OCTA were equal between early NTG and HTG, and therefore the involvement of vascular factors in NTG pathogenesis could not be confirmed. Our results confirm the preponderance of more frequent temporal RNFL involvement in early NTG.
Collapse
Affiliation(s)
- Urszula Łukasik
- Department of Diagnostics and Microsurgery of Glaucoma, Medical University of Lublin, Chmielna Str. 1, 20-079 Lublin, Poland; (U.Ł.); (D.W.-D.); (K.G.); (T.Ż.)
| | - Dominika Wróbel-Dudzińska
- Department of Diagnostics and Microsurgery of Glaucoma, Medical University of Lublin, Chmielna Str. 1, 20-079 Lublin, Poland; (U.Ł.); (D.W.-D.); (K.G.); (T.Ż.)
| | - Jaromir Jarecki
- Department of Rehabilitation and Orthopaedics, Medical University of Lublin, 20-079 Lublin, Poland
| | - Karolina Gasińska
- Department of Diagnostics and Microsurgery of Glaucoma, Medical University of Lublin, Chmielna Str. 1, 20-079 Lublin, Poland; (U.Ł.); (D.W.-D.); (K.G.); (T.Ż.)
| | - Tomasz Żarnowski
- Department of Diagnostics and Microsurgery of Glaucoma, Medical University of Lublin, Chmielna Str. 1, 20-079 Lublin, Poland; (U.Ł.); (D.W.-D.); (K.G.); (T.Ż.)
| | - Anna Święch
- Department of Vitreoretinal Surgery, Medical University of Lublin, 20-079 Lublin, Poland;
| | - Ewa Kosior-Jarecka
- Department of Diagnostics and Microsurgery of Glaucoma, Medical University of Lublin, Chmielna Str. 1, 20-079 Lublin, Poland; (U.Ł.); (D.W.-D.); (K.G.); (T.Ż.)
| |
Collapse
|
17
|
Lee MW, Yu HY, Park KS, Jin SY, Kim JS. A comparison of peripapillary vessel density between subjects with normal-tension glaucoma and primary open-angle glaucoma with similar extents of glaucomatous damage. Sci Rep 2023; 13:9258. [PMID: 37286792 DOI: 10.1038/s41598-023-36369-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 06/02/2023] [Indexed: 06/09/2023] Open
Abstract
The purpose of this study was to identify differences in retinal microvasculature impairments between patients with normal-tension glaucoma (NTG) and those with primary open-angle glaucoma (POAG) with similar extents of structural and visual field damage. Participants with glaucoma-suspect (GS), NTG, POAG, and normal controls were consecutively enrolled. Peripapillary vessel density (VD) and perfusion density (PD) were compared among the groups. Linear regression analyses were performed to identify the relationship between VD, PD and visual field parameters. The VDs of the full areas were 18.3 ± 0.7, 17.3 ± 1.7, 16.5 ± 1.7, and 15.8 ± 2.3 mm-1 in the control, GS, NTG, and POAG groups, respectively (P < 0.001). The VDs of the outer and inner areas and the PDs of all areas also differed significantly among the groups (all P < 0.001). In the NTG group, the VDs of the full, outer, and inner areas were significantly associated with all visual field parameters including the mean deviation (MD), pattern standard deviation (PSD), and visual field index (VFI). In the POAG group, the VDs of the full and inner areas were significantly associated with PSD and VFI but not with MD. In conclusion, with similar degrees of retinal nerve fiber layer thinning and visual field damage in both groups, the POAG group showed a lower peripapillary VD and PD than the NTG group. VD and PD were significantly associated with visual field loss.
Collapse
Affiliation(s)
- Min-Woo Lee
- Department of Ophthalmology, Konyang University College of Medicine, Daejeon, Republic of Korea.
| | - Hwa-Young Yu
- Department of Ophthalmology, Konyang University College of Medicine, Daejeon, Republic of Korea
| | - Kee-Sup Park
- Department of Ophthalmology, Konyang University College of Medicine, Daejeon, Republic of Korea
| | - Sun-Young Jin
- Department of Ophthalmology, Konyang University College of Medicine, Daejeon, Republic of Korea
- Modoo's Eye Clinic, #238, Daedeok-daero, Seo-gu, Daejeon, Republic of Korea
| | - Jin-Soo Kim
- Department of Ophthalmology, Chungnam National University Sejong Hospital, #20 Bodeum 7-ro, Sejong, Republic of Korea.
| |
Collapse
|
18
|
Hirasawa K, Yamaguchi J, Nagano K, Kanno J, Kasahara M, Shoji N. Degree of loss in the tissue thickness, microvascular density, specific perimetry and standard perimetry in early glaucoma. BMJ Open Ophthalmol 2023. [DOI: 10.1136/bmjophth-2023-001256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
Abstract
ObjectiveTo identify the degree of loss of the circumpapillary retinal nerve fibre layer (cpRNFL), the layer from the macular RNFL to the inner plexiform layer (mGCL++), circumpapillary (cpVD) and macular vascular density (mVD), Pulsar perimetry and standard perimetry in early glaucoma.MethodsIn this cross-sectional study, one eye from each of 96 healthy controls and 90 eyes with open-angle glaucoma were measured with cpRNFL, mGCL++, cpVD, mVD, Pulsar perimetry with Octopus P32 test (Pulsar) and standard perimetry with Humphrey field analyser 24-2 test (HFA). For direct comparison, all parameters were converted to relative change values adjusted in both their dynamic range and age-corrected normal value.ResultsThe degree of loss in mGCL++ (−24.7%) and cpRNFL (−25.8%) was greater than that in mVD (−17.3%), cpVD (−14.9%), Pulsar (−10.1%) and HFA (−5.9%) (each p<0.01); the degree of loss in mVD and cpVD was greater than that in Pulsar and HFA (each p<0.01); and the degree of loss in Pulsar was greater than that in HFA (p<0.01). The discrimination ability between glaucomatous and healthy eyes (area under the curve) was higher for mGCL++ (0.90) and cpRNFL (0.93) than for mVD (0.78), cpVD (0.78), Pulsar (0.78) and HFA (0.79).ConclusionThe degree of loss of cpRNFL and mGCL++ thickness preceded by approximately 7%–10% and 15%–20% compared with the micro-VD and visual fields in early glaucoma, respectively.Trial registration numberUMIN Clinical Trials Registry (http://www.umin.ac.jp/; R000046076 UMIN000040372).
Collapse
|
19
|
Lee YJ, Sun S, Kim YK, Jeoung JW, Park KH. Diagnostic ability of macular microvasculature with swept-source OCT angiography for highly myopic glaucoma using deep learning. Sci Rep 2023; 13:5209. [PMID: 36997639 PMCID: PMC10063664 DOI: 10.1038/s41598-023-32164-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Accepted: 03/23/2023] [Indexed: 04/01/2023] Open
Abstract
Macular OCT angiography (OCTA) measurements have been reported to be useful for glaucoma diagnostics. However, research on highly myopic glaucoma is lacking, and the diagnostic value of macular OCTA measurements versus OCT parameters remains inconclusive. We aimed to evaluate the diagnostic ability of the macular microvasculature assessed with OCTA for highly myopic glaucoma and to compare it with that of macular thickness parameters, using deep learning (DL). A DL model was trained, validated and tested using 260 pairs of macular OCTA and OCT images from 260 eyes (203 eyes with highly myopic glaucoma, 57 eyes with healthy high myopia). The DL model achieved an AUC of 0.946 with the OCTA superficial capillary plexus (SCP) images, which was comparable to that with the OCT GCL+ (ganglion cell layer + inner plexiform layer; AUC, 0.982; P = 0.268) or OCT GCL++ (retinal nerve fiber layer + ganglion cell layer + inner plexiform layer) images (AUC, 0.997; P = 0.101), and significantly superior to that with the OCTA deep capillary plexus images (AUC, 0.779; P = 0.028). The DL model with macular OCTA SCP images demonstrated excellent and comparable diagnostic ability to that with macular OCT images in highly myopic glaucoma, which suggests macular OCTA microvasculature could serve as a potential biomarker for glaucoma diagnosis in high myopia.
Collapse
Affiliation(s)
- Yun Jeong Lee
- Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Sukkyu Sun
- Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea
| | - Young Kook Kim
- Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Jin Wook Jeoung
- Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Ki Ho Park
- Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
| |
Collapse
|
20
|
Zhang Y, Sun X, Tian G, Chen Y. Comparison of the clinical and genetic features of autosomal dominant optic atrophy and normal tension glaucoma in young Chinese adults. Eye (Lond) 2023; 37:624-630. [PMID: 35273349 PMCID: PMC9998393 DOI: 10.1038/s41433-022-01990-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 01/30/2022] [Accepted: 02/15/2022] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND/OBJECTIVES To compare the clinical and optical coherence tomography (OCT) characteristics of autosomal dominant optic atrophy (ADOA) and normal tension glaucoma (NTG) in Chinese patients. SUBJECTS/METHODS Twenty-four unrelated patients with ADOA and 21 unrelated patients with NTG, younger than 30 years, were enrolled in this study. Data regarding the demographic and clinical characteristics of the patients were collected, and their peripapillary retinal nerve fibre layer (RNFL) and macular ganglion cell complex (GCC) thicknesses were evaluated using OCT. Sequencing of genes associated with neuro-ophthalmic disorders was performed for all patients. RESULTS The average age at onset of the ADOA group (13.92 ± 10.73 years) was significantly younger than that of the NTG group (23.67 ± 4.98 years, P = 0.002). Best-corrected visual acuity was significantly poorer in the ADOA group (0.75 ± 0.32) than in the NTG group (0.16 ± 0.19, P < 0.001). The average peripapillary RNFL thickness and the RNFL thicknesses in the temporal upper, temporal lower, and nasal lower sectors were significantly thinner in the ADOA group than in the NTG group (all P < 0.05). Moreover, the macular GCC thickness of the ADOA group was significantly thinner than that of the NTG group (P < 0.001). Twenty-three OPA1 variants (11 novel OPA1 variants) and one OPA3 variant were detected in 24 patients with ADOA. CONCLUSIONS Our study revealed a distinct difference between the patterns of RNFL and GCC loss in ADOA and NTG, which will help to differentiate ADOA from NTG in young patients. Additionally, this study expanded the genetic spectrum of ADOA.
Collapse
Affiliation(s)
- Youjia Zhang
- Department of Ophthalmology & Visual Science, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Xinghuai Sun
- Department of Ophthalmology & Visual Science, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Institutes of Brain Science, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Chinese Academy of Medical Sciences, and Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China
| | - Guohong Tian
- Department of Ophthalmology & Visual Science, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China.
| | - Yuhong Chen
- Department of Ophthalmology & Visual Science, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China.
- NHC Key Laboratory of Myopia, Chinese Academy of Medical Sciences, and Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China.
| |
Collapse
|
21
|
Mohammadzadeh V, Moghimi S, Nishida T, Mahmoudinezhad G, Kamalipour A, Micheletti E, Zangwill L, Weinreb RN. Effect of Corneal Hysteresis on the Rates of Microvasculature Loss in Glaucoma. Ophthalmol Glaucoma 2023; 6:177-186. [PMID: 35995420 DOI: 10.1016/j.ogla.2022.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 07/19/2022] [Accepted: 08/12/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE To investigate the association between corneal hysteresis (CH) and rates of optic nerve head whole image capillary density (wiCD) loss over time in open-angle glaucoma (OAG). DESIGN Observational cohort. PARTICIPANTS One hundred seventy-four eyes (122 OAG and 52 glaucoma suspect eyes) from 112 patients over more than 2 years and 4 visits or more. METHODS Baseline CH measurements were acquired with the Ocular Response Analyzer. Linear mixed-effect models were designed to investigate the effect of CH, average intraocular pressure (IOP) during follow-up, and baseline visual field (VF) mean deviation (MD) on the rates of wiCD loss and circumpapillary retinal nerve fiber layer (cpRNFL) thinning over time, while adjusting for confounders. Interaction between CH or baseline MD and average IOP during follow-up were included in final models to evaluate the effect of baseline MD or average IOP during follow-up on structural changes for different values of CH. MAIN OUTCOME MEASURE Effect of CH, IOP, and baseline MD on the rates of wiCD loss and cpRNFL thinning over time. RESULTS The average follow-up time was 3.9 years. In the multivariable model, non-Black race, higher average IOP during follow-up, lower baseline CH, lower baseline VF MD, and higher numbers of IOP-lowering medications were associated with faster rates of wiCD loss over time. For CH values 6 mmHg and 12 mmHg, every 1-mmHg increase in average IOP during follow-up was associated with 0.23% per year faster and 0.07% per year slower rates of wiCD loss over time, respectively. While every 1-mmHg decrease in CH was associated with 1.89% per year faster rate of wiCD loss for MD of -12 dB, it was associated with 0.81% per year faster rate of wiCD loss for MD of -3 dB. CONCLUSION Lower CH values were significantly associated with faster rates of wiCD loss over time. In eyes with lower CH, both higher average IOP during follow-up and more severe glaucoma damage at baseline were associated with faster rates of wiCD loss and cpRNFL thinning. These results support CH as a useful parameter for risk assessment of glaucoma progression. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found after the references.
Collapse
Affiliation(s)
- Vahid Mohammadzadeh
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California
| | - Sasan Moghimi
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California
| | - Takashi Nishida
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California
| | - Golnoush Mahmoudinezhad
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California
| | - Alireza Kamalipour
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California
| | - Eleonora Micheletti
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California
| | - Linda Zangwill
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California
| | - Robert N Weinreb
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California.
| |
Collapse
|
22
|
Mohammadzadeh V, Moghimi S, Nishida T, Proudfoot JA, Eslani M, Kamalipour A, El-Nimri N, Micheletti E, Zangwill LM, Weinreb RN. Longitudinal Structure-Function Relationship between Macular Vessel Density and Thickness and Central Visual Field in Early Glaucoma. Ophthalmol Glaucoma 2022; 5:648-657. [PMID: 35710087 PMCID: PMC10593185 DOI: 10.1016/j.ogla.2022.06.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 05/20/2022] [Accepted: 06/07/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE To investigate the relationship of longitudinal changes in macular vessel density (VD) from OCT angiography and in ganglion cell complex (GCC) from OCT with central visual field (VF) in eyes with early glaucoma. DESIGN Observational cohort. PARTICIPANTS A total of 95 eyes, 37 preperimetric and 58 with early glaucoma (24-2 VF mean deviation [MD] ≥ -6 decibels), with an average follow-up of 3.8 years and 5.3 visits, were included. METHODS Whole-image VD (wiVD) and whole-image GCC (wiGCC) and parafoveal scans, as well as localized regions of interest (LROIs), hemiretinae of whole images, and superior, inferior, temporal, and nasal sectors of parafoveal maps, were matched with central VF locations. Age-adjusted rates of change of VD, GCC, mean sensitivity of VF locations, and 10-2 VF MD were calculated using linear mixed-effect models. Normalized rates of change were calculated for comparison of change rates in wiVD and wiGCC. MAIN OUTCOME MEASURES Structure-function (SF) correlations of VD and GCC with central VF measurement change rates and comparison of different correlations of SF relationships after bootstrapping the difference of the correlation coefficients. RESULTS Vessel density loss and GCC thinning demonstrated significant correlations with central VF damage, globally and with most LROIs. The SF correlation (r, 95% confidence interval [CI]) between wiVD and 10-2 VF MD change rates was 0.42 [0.24, 0.58], whereas it was 0.27 [0.08, 0.45] between wiGCC and 10-2 VF MD changes rates (all P < 0.05). In contrast to GCC thinning, VD loss in the parafoveal sectors demonstrated significant correlations with central VF damage in inferior and temporal sectors. Differences in the relationship of SF with central VF damage were not significant between VD loss and GCC thinning. The mean (95% CI) normalized change rates of wiVD (-7.40 [-7.71 to 7.09] %/year) was faster than that of wiGCC (-2.39 [-2.94 to 1.84] %/year) (P < 0.05). CONCLUSIONS Rates of VD loss and GCC thinning are associated with central VF loss over time. Assessment of both macular VD and GCC thickness should be considered for evaluation of glaucoma progression.
Collapse
Affiliation(s)
- Vahid Mohammadzadeh
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California
| | - Sasan Moghimi
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California
| | - Takashi Nishida
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California
| | - James A Proudfoot
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California
| | - Medi Eslani
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California
| | - Alireza Kamalipour
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California
| | - Nevin El-Nimri
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California
| | - Eleonora Micheletti
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California
| | - Linda M Zangwill
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California
| | - Robert N Weinreb
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California; University of California, San Diego, La Jolla, California.
| |
Collapse
|
23
|
Hood DC, La Bruna S, Tsamis E, Leshno A, Melchior B, Grossman J, Liebmann JM, De Moraes CG. The 24-2 Visual Field Guided Progression Analysis Can Miss the Progression of Glaucomatous Damage of the Macula Seen Using OCT. Ophthalmol Glaucoma 2022; 5:614-627. [PMID: 35358755 PMCID: PMC9515237 DOI: 10.1016/j.ogla.2022.03.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 03/22/2022] [Accepted: 03/23/2022] [Indexed: 06/14/2023]
Abstract
PURPOSE To better understand the efficacy of the 24-2 guided progression analysis (GPA) in the detection of progression in eyes with early glaucoma (i.e., 24-2 mean deviation [MD] better than -6 dB) by comparing 24-2 GPA with a reference standard (RS) based on a combination of OCT and 24-2 and 10-2 visual field (VF) information. DESIGN Cross-sectional study. PARTICIPANTS Ninety-nine eyes from 99 individuals, including 70 suspected or early glaucomatous eyes (24-2 MD better than -6 dB) and 29 healthy controls (HCs). METHODS All the eyes had at least 4 OCT and VF test dates over a period that ranged from 12 to 59 months. The 24-2 VF tests included 2 baseline tests and at least 2 follow-up tests. The 2 baseline tests were performed within an average of 5.6 days (median, 7 days), and the last follow-up test was performed at least 1 year after the first baseline visit. MAIN OUTCOME MEASURES A commercial 24-2 GPA software, with default settings, characterized the eyes as having "likely progression" (LP) or "possible progression" (PP); both were considered "progressing" for this analysis. For RS, 3 authors graded progression using strict criteria and a combination of a custom OCT progression report and commercial 24-2 and 10-2 GPA reports for the same test dates as GPA. RESULTS The reference standard identified 10 (14%) of the 70 patient eyes and none of the HC eyes as having progression. The 24-2 guided progression analysis identified 13 of the 70 patient eyes as having progression (PP or LP). However, it correctly classified only 4 (40%) of the 10 RS progressors. All 6 of the RS progressors missed by the 24-2 GPA showed progression in the macula. In addition, the 24-2 GPA identified 2 of the 29 HC eyes as progressors and 9 patient eyes without progression based on the RS. CONCLUSIONS In eyes with early glaucoma (i.e., 24-2 MD, > -6 dB) in this study, the 24-2 GPA missed progression seen using OCT and exhibited a relatively high rate of false positives. Furthermore, the region progressing typically included the macula. The results suggest that including OCT and/or 10-2 VFs should improve the detection of progression.
Collapse
Affiliation(s)
- Donald C Hood
- Department of Psychology, Columbia University, New York, New York; Department of Ophthalmology, Bernard and Shirlee Brown Glaucoma Research Laboratory, Columbia University Irving Medical Center, New York, New York.
| | - Sol La Bruna
- Department of Psychology, Columbia University, New York, New York
| | - Emmanouil Tsamis
- Department of Psychology, Columbia University, New York, New York
| | - Ari Leshno
- Department of Ophthalmology, Bernard and Shirlee Brown Glaucoma Research Laboratory, Columbia University Irving Medical Center, New York, New York; Sackler Faculty of Medicine, Department of Ophthalmology, Tel Aviv University, Tel Aviv, Israel
| | - Bruna Melchior
- Department of Ophthalmology, Bernard and Shirlee Brown Glaucoma Research Laboratory, Columbia University Irving Medical Center, New York, New York; Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | | | - Jeffrey M Liebmann
- Department of Ophthalmology, Bernard and Shirlee Brown Glaucoma Research Laboratory, Columbia University Irving Medical Center, New York, New York
| | - Carlos Gustavo De Moraes
- Department of Ophthalmology, Bernard and Shirlee Brown Glaucoma Research Laboratory, Columbia University Irving Medical Center, New York, New York
| |
Collapse
|
24
|
Effects of Tafluprost on Ocular Blood Flow. Ophthalmol Ther 2022; 11:1991-2003. [DOI: 10.1007/s40123-022-00566-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 08/26/2022] [Indexed: 10/14/2022] Open
|
25
|
El-Nimri NW, Moghimi S, Penteado RC, Ghahari E, Yang D, Brye N, Proudfoot J, Do JL, Camp A, Salcedo M, Rubio V, Weinreb RN. Comparison of the Effects of Latanoprostene Bunod and Timolol on Retinal Blood Vessel Density: A Randomized Clinical Trial. Am J Ophthalmol 2022; 241:120-129. [PMID: 35526590 PMCID: PMC9444916 DOI: 10.1016/j.ajo.2022.04.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 03/30/2022] [Accepted: 04/26/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE To compare the differences in retinal vessel density (VD) between topical administration of latanoprostene bunod (LBN) ophthalmic solution 0.024% and timolol maleate 0.5% in patients with open-angle glaucoma (OAG) or ocular hypertension (OHT) and normal subjects. DESIGN Randomized, single center, crossover clinical trial. METHODS Eligible subjects were examined during 6 study visits over 12 weeks. All subjects were randomized in a 1:1 ratio to LBN dosed once daily or timolol dosed twice daily in both eyes (OU) for a duration of 4 weeks each, separated by a 2-week washout period. A comprehensive eye examination OU was performed at each visit. Testing was performed with optical coherence tomography and optical coherence tomography angiography (optic nerve and macula), as well as visual field examination, on the study eye at baseline and before and after each treatment. RESULTS One eye from each of 50 patients was enrolled (10 healthy patients, 26 patients with OHT, and 14 patients with OAG). After administration of LBN there was significantly increased macular VD (0.76% [0.20%-1.33%], P = 0.009) and a trend in increasing peripapillary VD in patients with OAG and patients with OHT. In contrast, after administration of timolol, there were no differences in macular VD, and a decrease in peripapillary VD only was observed in the nasal inferior sector (-0.56% [-1.08% to -0.03%], P = .04) in patients with OAG and patients with OHT. No change in peripapillary or macular VD was observed in the normal subjects (P > .05 for all). CONCLUSIONS Topical administration of LBN enhanced macular VD in patients with OAG or patients with OHT. In contrast, timolol administration did not have any effect on VD.
Collapse
Affiliation(s)
- Nevin W El-Nimri
- From the Hamilton Glaucoma Center (N.W.E., S.M., R.C.P., E.G., N.B., J.P., J.L.D., A.C., M.S., V.R., R.N.W.), Shiley Eye Institute, and the Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
| | - Sasan Moghimi
- From the Hamilton Glaucoma Center (N.W.E., S.M., R.C.P., E.G., N.B., J.P., J.L.D., A.C., M.S., V.R., R.N.W.), Shiley Eye Institute, and the Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
| | - Rafaella C Penteado
- From the Hamilton Glaucoma Center (N.W.E., S.M., R.C.P., E.G., N.B., J.P., J.L.D., A.C., M.S., V.R., R.N.W.), Shiley Eye Institute, and the Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
| | - Elham Ghahari
- From the Hamilton Glaucoma Center (N.W.E., S.M., R.C.P., E.G., N.B., J.P., J.L.D., A.C., M.S., V.R., R.N.W.), Shiley Eye Institute, and the Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
| | - Diya Yang
- Beijing Tongren Eye Center (D.Y.), Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Nicole Brye
- From the Hamilton Glaucoma Center (N.W.E., S.M., R.C.P., E.G., N.B., J.P., J.L.D., A.C., M.S., V.R., R.N.W.), Shiley Eye Institute, and the Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
| | - James Proudfoot
- From the Hamilton Glaucoma Center (N.W.E., S.M., R.C.P., E.G., N.B., J.P., J.L.D., A.C., M.S., V.R., R.N.W.), Shiley Eye Institute, and the Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
| | - Jiun L Do
- From the Hamilton Glaucoma Center (N.W.E., S.M., R.C.P., E.G., N.B., J.P., J.L.D., A.C., M.S., V.R., R.N.W.), Shiley Eye Institute, and the Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
| | - Andrew Camp
- From the Hamilton Glaucoma Center (N.W.E., S.M., R.C.P., E.G., N.B., J.P., J.L.D., A.C., M.S., V.R., R.N.W.), Shiley Eye Institute, and the Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
| | - Matthew Salcedo
- From the Hamilton Glaucoma Center (N.W.E., S.M., R.C.P., E.G., N.B., J.P., J.L.D., A.C., M.S., V.R., R.N.W.), Shiley Eye Institute, and the Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
| | - Veronica Rubio
- From the Hamilton Glaucoma Center (N.W.E., S.M., R.C.P., E.G., N.B., J.P., J.L.D., A.C., M.S., V.R., R.N.W.), Shiley Eye Institute, and the Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
| | - Robert N Weinreb
- From the Hamilton Glaucoma Center (N.W.E., S.M., R.C.P., E.G., N.B., J.P., J.L.D., A.C., M.S., V.R., R.N.W.), Shiley Eye Institute, and the Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA.
| |
Collapse
|
26
|
Ghahari E, Bowd C, Zangwill LM, Proudfoot JA, Penteado RC, Kyung H, Hou H, Moghimi S, Weinreb RN. The Association Between Regional Macula Vessel Density and Central Visual Field Damage in Advanced Glaucoma Eyes. J Glaucoma 2022; 31:734-743. [PMID: 35654344 PMCID: PMC10695567 DOI: 10.1097/ijg.0000000000002055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 05/07/2022] [Indexed: 11/26/2022]
Abstract
PRCIS Both macular superficial vessel density and ganglion cell complex (GCC) thickness measurement are significantly associated with regional and global 10-degree central visual field (VF) sensitivity in advanced glaucoma. PURPOSE The purpose of this study was to evaluate the regional and global structure-function relationships between macular vessel density (MVD) assessed by optical coherence tomography angiography (OCTA) and 10-2 VF sensitivity in advanced open angle glaucoma eyes. METHODS Macular OCTA and 10-2 VF sensitivity of 44 patients [mean deviation (MD) <-10 dB] were evaluated. Regional and global VF mean sensitivity (MS) was calculated from total deviation plots. Superficial and deep MVD were obtained from 3 × 3 and 6×6 mm 2 OCTA scans using 2 sectoral definitions. Spectral-domain optical coherence tomography macular GCC thickness was obtained simultaneously from the same scan as the MVD measurements. Linear regression models were used to assess the associations ( R2 ). RESULTS Lower MS was significantly associated with a reduction in superficial MVD and GCC in each region of both scan sizes for both maps. Associations were weaker in the individual sectors of the whole image grid than the Early Treatment Diabetic Retinopathy Study map. Deep-layer MVD was not associated with central MS. Although 6×6 mm 2 and perifoveal vessel density had better associations with central 10-degree MS compared with GCC thickness (eg, R2 from 25.7 to 48.1 µm and 7.8% to 32.5%, respectively), GCC associations were stronger than MVD associations in the central 5-degree MS. CONCLUSIONS Given a stronger MVD-central 10-degree VF association compared with GCC, as well as stronger GCC-central 5-degree VF association compared with MVD, MVD and GCC are complementary measurements in eyes with advanced glaucoma. A longitudinal analysis is needed to determine the relative utility of the GCC and MVD measurements.
Collapse
Affiliation(s)
- Elham Ghahari
- Viterbi Family Department of Ophthalmology, Hamilton Glaucoma Center, Shiley Eye Institute, University of California, San Diego, La Jolla, CA
| | | | | | | | | | | | | | | | | |
Collapse
|
27
|
Tong YX, Zhang XY, He Y, Chen ZL, Jiang B. Optical coherence tomography evaluation of retinal nerve fiber layer thickness in non-arteritic anterior ischemic optic neuropathy and primary open angle glaucoma: a systematic review and Meta-analysis. Int J Ophthalmol 2022; 15:1370-1380. [PMID: 36017036 DOI: 10.18240/ijo.2022.08.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 01/27/2022] [Indexed: 11/23/2022] Open
Abstract
AIM To assess the differences in average and sectoral peripapillary retinal nerve fiber layer (pRNFL) thickness using spectral domain optical coherence tomography (SD-OCT) in patients with non-arteritic anterior ischemic neuropathy (NAION) compared with those with primary open angle glaucoma (POAG). METHODS A comprehensive literature search of the PubMed, Cochrane Library, and Embase databases were performed prior to October, 2021. Studies that compared the pRNFL thickness in NAION eyes with that in POAG eyes with matched mean deviation of the visual fields were included. The weighted mean difference (WMD) with 95% confidence interval (CI) was used to pool continuous outcomes. RESULTS Ten cross-sectional studies (11 datasets) comprising a total of 625 eyes (278 NAION eyes, 347 POAG eyes) were included in the qualitative and quantitative analyses. The pooled results demonstrated that the superior pRNFL was significantly thinner in NAION eyes than in POAG eyes (WMD=-6.40, 95%CI: -12.22 to -0.58, P=0.031), whereas the inferior pRNFL was significant thinner in POAG eyes than in NAION eyes (WMD=11.10, 95%CI: 7.06 to 15.14, P≤0.001). No difference was noted concerning the average, nasal, and temporal pRNFL thickness (average: WMD=1.45, 95%CI: -0.75 to 3.66, P=0.196; nasal: WMD=-2.12, 95%CI: -4.43 to 0.19, P=0.072; temporal: WMD=-1.24, 95%CI: -3.96 to 1.47, P=0.370). CONCLUSION SD-OCT based evaluation of inferior and superior pRNFL thickness can be potentially utilized to differentiate NAION from POAG, and help to understand the different pathophysiological mechanisms between these two diseases. Further longitudinal studies and studies using eight-quadrant or clock-hour classification method are required to validate the obtained findings.
Collapse
Affiliation(s)
- Yu-Xin Tong
- Department of Ophthalmology, Second Xiangya Hospital, Central South University, Changsha 410011, Hunan Province, China.,Hunan Clinical Research Center of Ophthalmic Disease, Changsha 410011, Hunan Province, China
| | - Xin-Yu Zhang
- Department of Ophthalmology, Second Xiangya Hospital, Central South University, Changsha 410011, Hunan Province, China.,Hunan Clinical Research Center of Ophthalmic Disease, Changsha 410011, Hunan Province, China
| | - Yi He
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha 410008, Hunan Province, China
| | - Zong-Lin Chen
- Department of General Surgery, Second Xiangya Hospital, Central South University, Changsha 410011, Hunan Province, China
| | - Bing Jiang
- Department of Ophthalmology, Second Xiangya Hospital, Central South University, Changsha 410011, Hunan Province, China.,Hunan Clinical Research Center of Ophthalmic Disease, Changsha 410011, Hunan Province, China
| |
Collapse
|
28
|
Peripapillary and Macular Vascular Density in Patients with Preperimetric and Early Primary Open-Angle Glaucoma. J Glaucoma 2022; 31:724-733. [DOI: 10.1097/ijg.0000000000002069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 06/03/2022] [Indexed: 11/27/2022]
|
29
|
Hirasawa K, Yamaguchi J, Nagano K, Kanno J, Kasahara M, Shoji N. Structure–Function Relationships and Glaucoma Detection with Magnification Correction of OCT Angiography. OPHTHALMOLOGY SCIENCE 2022; 2:100120. [PMID: 36249704 PMCID: PMC9562297 DOI: 10.1016/j.xops.2022.100120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/13/2022] [Accepted: 01/24/2022] [Indexed: 11/03/2022]
Abstract
Purpose To investigate the effects of adjusting the ocular magnification during OCT-based angiography imaging on structure–function relationships and glaucoma detection. Design Cross-sectional study. Participants A total of 96 healthy control participants and 90 patients with open-angle glaucoma were included. Methods One eye of each patient in the control group and the patient group was evaluated. The layers comprising the macula vascular density (VD) and circumpapillary VD were derived from swept-source OCT angiography imaging. The mean sensitivity (MS) of the standard automated perimetry was measured using the Humphrey 24-2 test. Structure–function relationships were evaluated with simple and partial correlation coefficients. A receiver operating characteristic analysis was performed to evaluate the diagnostic accuracy for glaucoma using the area under the receiver operating characteristic curve (AUC). Ocular magnification was adjusted using Littmann’s formula modified by Bennett. Main Outcome Measures The association between the axial length and VD, structure–function relationships, and glaucoma detection with and without magnification correction. Results The superficial layer of the macular region was not significantly correlated to the axial length without magnification correction (r = 0.0011; P = 0.99); however, it was negatively correlated to the axial length with magnification correction (r = –0.22; P = 0.028). Regarding the nerve head layer in the circumpapillary region, a negative correlation to the axial length without magnification correction was observed (r = –0.22; P = 0.031); however, this significant correlation disappeared with magnification correction. The superficial layer of the macula and the nerve head layer of the circumpapillary region were significantly correlated to Humphrey 24-2 MS values without magnification correction (r = 0.22 and r = 0.32, respectively); however, these correlations did not improve after magnification correction (r = 0.20 and r = 0.33, respectively). Glaucoma diagnostic accuracy in the superficial layer (AUC, 0.63) and nerve head layer (AUC, 0.70) without magnification correction did not improve after magnification correction (AUC, 0.62 and 0.69, respectively). Conclusions Adjustment of the ocular magnification is important for accurate VD measurements; however, it may not significantly impact structure–function relationships and glaucoma detection.
Collapse
|
30
|
Diagnostic ability and sectoral structure-function relationship of circumpapillary and macular superficial vessel density in early glaucomatous eyes. Sci Rep 2022; 12:5991. [PMID: 35397629 PMCID: PMC8994769 DOI: 10.1038/s41598-022-10033-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 03/29/2022] [Indexed: 11/26/2022] Open
Abstract
This study aimed to evaluate the diagnostic ability and sectoral structure function relationship of circumpapillary vessel density (cpVD) and macular vessel density (mVD) with optical coherence tomography angiography (OCTA) in early glaucomatous (EG) eyes. 224 EG eyes of 167 patients (mean deviation (MD) > − 6 dB) and 70 normal eyes of 70 subjects were enrolled in this retrospective cross-sectional study. All patients underwent OCT and OCTA scanning. Diagnostic abilities were evaluated with area under receiver operating characteristic curves (AUROC). Structure function relationships of superior, inferior and Garway-Heath sectoral values with its corresponding visual field (VF) sensitivity were determined using linear mixed models. AUROCs were 0.798, 0.621, 0.876 and 0.835 for cpVD, mVD, circumpapillary retinal nerve fiber layer thickness (cpRNFLT) and ganglion cell-inner plexiform layer, respectively. AUROC of cpVD was significantly lower than cpRNFLT (P = 0.010) and higher than mVD (P < 0.001). All Garway-Heath sectors of cpVD significantly correlated with its corresponding VF sensitivity except for the nasal sector. MVD also showed significant structure function relationship and the correlations were stronger in the perifoveal region (6 mm annulus) than in the parafoveal region (3 mm annulus). CpVD demonstrated moderate diagnostic ability and both cpVD and mVD demonstrated significant association with VF sensitivity in EG eyes.
Collapse
|
31
|
Relationship Between Macular Microvasculature and Visual Acuity in Advanced and Severe Glaucoma. Am J Ophthalmol 2022; 236:154-163. [PMID: 34653358 DOI: 10.1016/j.ajo.2021.10.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 10/04/2021] [Accepted: 10/05/2021] [Indexed: 11/22/2022]
Abstract
PURPOSE To evaluate the correlation between structural parameters and visual acuity (VA) in advanced glaucoma. DESIGN Prospective, cross-sectional study. METHODS A total of 238 eyes from 238 patients (82 were men and mean ± SD age was 59.9 ± 13.8 years) from a tertiary center were divided into an advanced (mean deviation of 24-2 visual field tests from -12.01 to -20.0 dB) and severe (< -20 dB) glaucoma group. Structural parameters were obtained by RTVue (Optovue Inc) optical coherence tomography and angiography. Pearson correlation, partial correlation adjusted for age and axial length, and receiver operating characteristic curves to detect decreased VA (<20/25) were performed. RESULTS In the advanced glaucoma group (133 eyes), superficial (Pearson correlation coefficient, r = -0.46, P < .001; partial correlation coefficient, r' = -0.30, P < .001) and deep macular vessel densities (VDs) (r = -0.47, P < .001; r' = -0.30, P < .001) showed highest correlation with VA. The area under the receiver operating characteristic curves of the superficial parafoveal/macular VDs were 0.816 (95% CI, 0.735-0.897) and 0.808 (95% CI, 0.725-0.891), respectively. In the severe glaucoma group (105 eyes), deep nasal grid VD (r = -0.31, P = 0.002; r' = -0.35, P < .001) showed highest correlation with VA. Deep macular VD showed better correlation with VA than other structural parameters. The area under the receiver operating characteristic curves of deep macular VD and deep nasal grid VD were 0.740 (95% CI, 0.632-0.849) and 0.748 (95% CI, 0.640-0.857), respectively. CONCLUSIONS Macular VD showed better correlation with VA in advanced glaucoma. Deep macular VD, especially nasal grid, may be a promising structural parameter in severe glaucoma.
Collapse
|
32
|
Macular Thickness and Microvasculature Loss in Glaucoma Suspect Eyes. Ophthalmol Glaucoma 2022; 5:170-178. [PMID: 34339877 PMCID: PMC9988288 DOI: 10.1016/j.ogla.2021.07.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 07/22/2021] [Accepted: 07/26/2021] [Indexed: 01/22/2023]
Abstract
PURPOSE To characterize the change of ganglion cell complex (GCC) thickness and macular vessel density in glaucoma suspect eyes with ocular hypertension (OHT) or glaucomatous optic neuropathy (GON). DESIGN Prospective, longitudinal study. PARTICIPANTS Eight-three eyes (24 healthy, 30 OHT, and 29 GON) of 65 patients who underwent at least 3 visits were included from the Diagnostic Innovations in Glaucoma Study. The mean follow-up was at least 3 years. METHODS OCT angiography (OCTA)-based vessel density and OCT-based structural thickness of the 3 × 3-mm1 GCC scan slab were evaluated at each visit. The rates of vessel density and thickness change were compared across diagnostic groups using a linear mixed-effects model. MAIN OUTCOME MEASURES Change rates of macula GCC thickness and superficial vessel density. RESULTS Significant mean rates of both GCC thinning and vessel density loss were detectable in OHT and GON groups. Of the individual suspect eyes, 49.1% showed significant loss (P < 0.05) with either vessel density or GCC thickness. Of the GON eyes, 31.0% showed both significant GCC loss and vessel density loss, 51.7% showed only significant GCC loss, whereas 17.2% showed only significant vessel density loss. Vessel density loss was faster than GCC thinning in half of the suspect eyes based on percent loss analysis. The age and scan quality-adjusted GCC thinning rates of the OHT group (-0.59 μm/year; P = 0.025) and GON group (-0.79 μm/year; P = 0.058) were faster than those of the healthy group (-0.11 μm/year), whereas the rate of vessel density loss was not significantly different among the diagnostic groups (all P > 0.2). Higher mean intraocular pressure during follow-up was associated with faster GCC thinning in the OHT group (P = 0.065) and GON groups (P = 0.015), but was not associated with the rate of vessel density decrease. CONCLUSIONS Whereas the rate of GCC thinning was faster on average in suspect eyes than in healthy eyes, some suspect eyes showed significant loss of vessel density and faster vessel density loss than GCC thinning. OCT and OCTA are complementary and useful for evaluating eyes with OHT or GON.
Collapse
|
33
|
Safizadeh M, Shaabani A, Kamalipour A, Fard MA, Yeh K, Yaseri M, Hamzeh N, Khatibi N, Rao HL, Weinreb R, Moghimi S. Optic nerve head vessel density in different stages of pseudoexfoliation disease. Br J Ophthalmol 2022; 106:223-228. [PMID: 33246938 PMCID: PMC10042174 DOI: 10.1136/bjophthalmol-2020-317605] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 10/01/2020] [Accepted: 10/22/2020] [Indexed: 01/22/2023]
Abstract
PURPOSE To evaluate the superficial vascular density of the optic nerve head in different stages of pseudoexfoliation disease using optical coherence tomography angiography (OCTA). METHODS In this cross-sectional study, 57 normal eyes, 41 eyes with pseudoexfoliation syndrome (PXS), 82 eyes with pseudoexfoliation glaucoma (PXG) and 27 non-glaucomatous fellow eyes of PXG (NL-PXG) that had OCTA were included. Circumpapillary RNFL (cpRNFL) thickness and circumpapillary capillary density (cpCD) were compared among the groups after adjusting for confounders using linear-mixed model. RESULTS PXG eyes had thinner global RNFL and lower cpCD (74.2±14.3 µm and 36.7±10.0%) than control (103.3±8.6 µm and 52.5±2.3%), PXS (96.8±8.8 µm and 51.5±2.3%), and NL-PXG eyes (96.3±11.1 µm and 50.1±3.9%) (p<0.001). After adjustment for age, gender and signal strength index, global cpRNFL thickness was comparable among control, PXS and NL-PXG. NL-PXG had the lowest cpCD (p=0.045) and sectoral cpCD compared to PXS and control eyes. Although cpCD was comparable between control and PXS (p=0.425) eyes, sectoral differences (p=0.009 and 0.004, for inferonasal and temporal-inferior cpCD, respectively) were detectable between the two groups. AUROC for differentiating NL-PXG eyes from normal were better for cpCD (0.78) compared to cpRNLF (0.69). CONCLUSIONS OCTA can detect reduced capillary density before significant changes in cpRNFL in fellow eyes of PXG patients. This can enable earlier detection of glaucomatous loss in pseudoexfoliation disease and enhance management of the disease.
Collapse
Affiliation(s)
- Mona Safizadeh
- Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Amirreza Shaabani
- Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Alireza Kamalipour
- Viterbi Family Department of Ophthalmology, Shiley Eye Institute, University of California, University of California at San Diego Department of Ophthalmology at the Shiley Eye Institute, La Jolla, California, USA
| | - Masoud Aghsaei Fard
- Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Kaileen Yeh
- Viterbi Family Department of Ophthalmology, Shiley Eye Institute, University of California, University of California at San Diego Department of Ophthalmology at the Shiley Eye Institute, La Jolla, California, USA
| | - Mehdi Yaseri
- Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Nikoo Hamzeh
- Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Nassim Khatibi
- Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | | | - Robert Weinreb
- Viterbi Family Department of Ophthalmology, Shiley Eye Institute, University of California, University of California at San Diego Department of Ophthalmology at the Shiley Eye Institute, La Jolla, California, USA
| | - Sasan Moghimi
- Viterbi Family Department of Ophthalmology, Shiley Eye Institute, University of California, University of California at San Diego Department of Ophthalmology at the Shiley Eye Institute, La Jolla, California, USA
| |
Collapse
|
34
|
Chang PY, Wang JY, Wang JK, Huang TL, Hsu YR. Optical Coherence Tomography Angiography Compared With Optical Coherence Tomography for Detection of Early Glaucoma With High Myopia. Front Med (Lausanne) 2022; 8:793786. [PMID: 35087847 PMCID: PMC8786801 DOI: 10.3389/fmed.2021.793786] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 12/08/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose: To investigate the diagnostic abilities of the perfusion density (PD) and structural thickness parameters in the peripapillary and macular regions measured by optical coherence tomography angiography (OCTA) and optical coherence tomography (OCT) and to test if their diagnostic abilities of early glaucoma are different between highly myopic (HM) and non-highly myopic (NHM) patients. Methods: A total of 75 glaucoma patients and 65 controls were included in the analyses. The glaucoma detection abilities of macular PD and peripapillary PD, along with macular ganglion cell-inner plexiform layer (mGCIPL) thickness and peripapillary retinal nerve fiber layer (pRNFL) thicknesses were compared between the HM and NHM group. Diagnostic ability was assessed by area under the receiver operating characteristics (AUC) curves, adjusted by age, axial length, and signal strength. Results: The diagnostic ability of macular PD and mGCIPL thickness had no significant difference in both HM and NHM groups. However, the diagnostic ability of peripapillary PD except in the temporal section was significantly lower in the HM group than in the NHM group (all p < 0.05). The diagnostic ability of the superior, nasal, and average pRNFL thickness was also significantly lower in the HM group than in the NHM group (all p < 0.05). Conclusion: This study demonstrated that although peripapillary PD and macular PD were both significantly reduced in patients with highly myopia, the diagnostic ability of peripapillary PD in HM patients was significantly lower than that in NHM patients, while macular PD was not. Macular OCTA along with OCT imaging should be included in the imaging algorithm in early glaucoma diagnosis in highly myopic patients.
Collapse
Affiliation(s)
- Pei-Yao Chang
- Department of Ophthalmology, Far Eastern Memorial Hospital, New Taipei City, Taiwan.,Department of Medicine, National Taiwan University Hospital, Taipei, Taiwan.,Department of Healthcare Administration, Asia University, Taichung, Taiwan.,Department of Electrical Engineering, Yuan Ze University, Taoyuan City, Taiwan
| | - Jiun-Yi Wang
- Department of Healthcare Administration, Asia University, Taichung, Taiwan.,Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Jia-Kang Wang
- Department of Ophthalmology, Far Eastern Memorial Hospital, New Taipei City, Taiwan.,Department of Medicine, National Taiwan University Hospital, Taipei, Taiwan.,Department of Electrical Engineering, Yuan Ze University, Taoyuan City, Taiwan.,Department of Healthcare Administration and Department of Nursing, Oriental Institute of Technology, New Taipei City, Taiwan
| | - Tzu-Lun Huang
- Department of Ophthalmology, Far Eastern Memorial Hospital, New Taipei City, Taiwan.,Department of Electrical Engineering, Yuan Ze University, Taoyuan City, Taiwan
| | - Yung-Ray Hsu
- Department of Ophthalmology, Far Eastern Memorial Hospital, New Taipei City, Taiwan.,Department of Medicine, National Taiwan University Hospital, Taipei, Taiwan.,Department of Electrical Engineering, Yuan Ze University, Taoyuan City, Taiwan
| |
Collapse
|
35
|
Beni AN, Dehghani A, Kianersi F, Ghanbari H, Habibi Z, Memarzadeh E, Beni ZN. Retinal findings of COVID-19 patients using Ocular coherence tomography angiography two to three months after infection: Ocular appearance recovered COVID-19 patient. Photodiagnosis Photodyn Ther 2022; 38:102726. [PMID: 35051664 PMCID: PMC8762816 DOI: 10.1016/j.pdpdt.2022.102726] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 01/10/2022] [Accepted: 01/14/2022] [Indexed: 02/06/2023]
Abstract
Purpose The aim of this study was to evaluate the ocular disorders in COVID-19 patients, two to three months after infection. Methods In this cross-sectional, historically controlled study, fifty-one COVID-19 patients were compared with thirty-seven age, and gender-matched healthy individuals. After complete ophthalmological examination, all participants underwent peripapillary and macular optical coherence tomography, and optical coherence tomography angiography (OCTA) measurements (OptoVue Inc, Freemont, CA, USA). Results The time between the initial onset of symptoms, and ophthalmologic examination was 63.31±15.21 (40–95 days). Ophthalmic examination of all the recovered COVID-19 patients was within normal range. None of the peripapillary and macular OCTA parameters were significantly different between the two groups with pairwise comparisons, but after adjusting for age, gender, axial length, and signal strength index (SSI), recovered COVID-19 eyes showed a significant increase in peripapillary retinal nerve fiber (RNFL) thickness, superficial, and deep macular vessel densities in parafoveal and perifoveal regions compared with healthy control eyes (p<= 0.05). Inner retinal thickness overall is higher in recovered COVID-19 eyes compared to healthy eyes after adjustment. Conclusion Patients with moderate-intensity SARS-CoV-2 pneumonia had altered peripapillary and macular vessel density compared to healthy subjects. Further investigation is warranted to analyze the correlation of these changes with disease severity as well as evolution of these changes over time.
Collapse
Affiliation(s)
- Afsaneh Naderi Beni
- Isfahan Eye Research Center, Department of ophthalmology, Isfahan University of medical sciences, Isfahan, Iran.
| | - Alireza Dehghani
- Isfahan Eye Research Center, Department of ophthalmology, Isfahan University of medical sciences, Isfahan, Iran
| | - Farzan Kianersi
- Isfahan Eye Research Center, Department of ophthalmology, Isfahan University of medical sciences, Isfahan, Iran
| | - Heshmatollah Ghanbari
- Isfahan Eye Research Center, Department of ophthalmology, Isfahan University of medical sciences, Isfahan, Iran
| | | | | | | |
Collapse
|
36
|
Cheng W, Song Y, Lin F, Xiong J, Li F, Jin L, Wang Z, Yang C, Yang B, Wang F, Ning G, Wang W, Zhang X. Assessment of Artifacts in Swept-Source Optical Coherence Tomography Angiography for Glaucomatous and Normal Eyes. Transl Vis Sci Technol 2022; 11:23. [PMID: 35040917 PMCID: PMC8764211 DOI: 10.1167/tvst.11.1.23] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To evaluate the frequency of and identify the factors that influence the artifacts of swept-source optical coherence tomography angiography (SS-OCTA) in glaucomatous and normal eyes. Methods Artifacts of OCTA images of open-angle glaucoma (OAG) and normal subjects were analyzed using SS-OCTA. Univariate and multivariate logistic regression analyses were performed to evaluate the association of age, sex, best-corrected visual acuity, axial length (AL), intraocular pressure, presence and severity of OAG, and image quality score (IQS) with the presence of artifacts. Results Images from 4426 subjects were included in the study. At least one type of artifact was present in 24.54% of the images. The most common artifacts were occurrence of motion (705 eyes, 15.93%), followed by defocus (628 eyes, 14.19%), decentration (134 eyes, 3.03%), masking (62 eyes,1.40%), and segmentation errors (23 eyes, 0.52%). Multivariate logistic analyses showed that the presence of OAG (odds ratio [OR] = 2.71; 95% confidence interval [CI], 2.09-3.51; P < 0.001), female sex (OR = 1.34; 95% CI, 1.12-1.61; P = 0.001), longer AL (OR = 1.09; 95% CI, 1.02-1.17; P = 0.017), and IQS < 40 (OR = 3.75; 95% CI, 3.15-4.48; P < 0.001) were significantly associated with higher odds for the presence of any artifact. The IQS had poor performance for detecting artifacts, with an area under the curve of 0.723, sensitivity of 73.04%, and specificity of 62.53%. Conclusions OAG eyes had more SS-OCTA image artifacts than normal eyes. IQS is an imperfect tool for identifying artifacts. Translational Relevance Special attention should be paid to the effect of artifacts when using SS-OCTA in the clinical setting to assess vascular parameters in patients with glaucoma.
Collapse
Affiliation(s)
- Weijing Cheng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Yunhe Song
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Fengbin Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Jian Xiong
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Fei Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Ling Jin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Zhenyu Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Chunman Yang
- Department of Ophthalmology, The Second Affiliated Hospital of Guizhou Medical University, Guizhou, China
| | - Bin Yang
- Department of Ophthalmology, Zigong Third People's Hospital, Zigong, China
| | - Fanyin Wang
- Department of Ophthalmology, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, China
| | - Guili Ning
- Department of Ophthalmology, Guizhou Aerospace Hospital, Zunyi, China
| | - Wei Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Xiulan Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| |
Collapse
|
37
|
Saks D, Schulz A, Sheriff S, Shen T, Gupta V, Qassim A, Ridge B, Pham R, Craig J, Graham S. Quantification of localised vascular wedge-shaped defects in glaucoma. Clin Exp Ophthalmol 2022; 50:724-735. [PMID: 35796092 PMCID: PMC9796144 DOI: 10.1111/ceo.14134] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 06/15/2022] [Accepted: 07/03/2022] [Indexed: 01/01/2023]
Abstract
BACKGROUND Vascular dysfunction plays a considerable role in glaucoma pathogenesis. Previous glaucoma case studies described localised wedge-shaped vascular defects, similar to retinal nerve fibre layer (RNFL) wedge defects. This study investigates the prevalence and quantification of this vessel loss, in relation to primary open angle glaucoma (POAG) parameters. METHODS This study included 608 eyes (351 participants): 192 PROGRESSA study participants (342 eyes) with suspect, preperimetric or early manifest POAG, observed for vascular wedge defect presence (cohort one); an additional 114 individuals (cohort two-208 eyes) with POAG at various stages of progression for wedge characterisation; and 38 controls (56 eyes). Vascular wedge defects were observed using optical coherence tomography angiography (OCTA). Wedge parameters and vessel densities were quantified using ImageJ software. RNFL and ganglion cell layer inner plexiform layer (GCLIPL) from OCT scans, and mean deviation (Humphrey visual field 24-2) were also assessed. RESULTS Vascular wedge defects were found in 45/342 eyes (13.2%) in cohort one, in 41/208 eyes (19.7%) in cohort two and were not found in controls. Wedge defects were mostly inferotemporal (80%), and present at all disease stages. They were associated with visual field loss in the opposite hemisphere, thinner RNFL (p < 0.001), thinner GCLIPL (p = 0.003), and focal RNFL loss corresponding with the vascular defect region. CONCLUSION Vascular wedge defects are present at all POAG stages even before functional change and are strongly concordant with focal RNFL loss. Further research is needed to explore these defects in particular their temporal relationship with clinical measures of POAG.
Collapse
Affiliation(s)
- Danit Saks
- Department of Clinical MedicineMacquarie UniversitySydneyNew South WalesAustralia
| | - Angela Schulz
- Department of Clinical MedicineMacquarie UniversitySydneyNew South WalesAustralia
| | - Samran Sheriff
- Department of Clinical MedicineMacquarie UniversitySydneyNew South WalesAustralia
| | - Ting Shen
- Department of Clinical MedicineMacquarie UniversitySydneyNew South WalesAustralia
| | - Vivek Gupta
- Department of Clinical MedicineMacquarie UniversitySydneyNew South WalesAustralia
| | - Ayub Qassim
- Department of Ophthalmology, Flinders Health and Medical Research InstituteFlinders UniversityAdelaideSouth AustraliaAustralia
| | - Bronwyn Ridge
- Department of Ophthalmology, Flinders Health and Medical Research InstituteFlinders UniversityAdelaideSouth AustraliaAustralia
| | - Ryan Pham
- Department of Ophthalmology, Flinders Health and Medical Research InstituteFlinders UniversityAdelaideSouth AustraliaAustralia
| | - Jamie Craig
- Department of Ophthalmology, Flinders Health and Medical Research InstituteFlinders UniversityAdelaideSouth AustraliaAustralia
| | - Stuart Graham
- Department of Clinical MedicineMacquarie UniversitySydneyNew South WalesAustralia
| | | |
Collapse
|
38
|
The Diagnostic Value of Pulsar Perimetry, Optical Coherence Tomography, and Optical Coherence Tomography Angiography in Pre-Perimetric and Perimetric Glaucoma. J Clin Med 2021; 10:jcm10245825. [PMID: 34945121 PMCID: PMC8706528 DOI: 10.3390/jcm10245825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 11/28/2021] [Accepted: 12/11/2021] [Indexed: 11/23/2022] Open
Abstract
The purpose of this article is to investigate the diagnostic value of Pulsar perimetry (PP), optical coherence tomography (OCT), and optical coherence tomography angiography (OCTA) in pre-perimetric glaucoma (PPG) and perimetric glaucoma (PG). This retrospective cross-sectional study included 202 eyes (145 eyes in the control group, 40 eyes in the PPG group, and 17 eyes in the PG group) from 105 subjects. The results were analyzed by paired t-tests and Wilcoxon signed-rank test. The area under the curve (AUC), sensitivity, and specificity were used to evaluate the diagnostic accuracy. Pearson correlation was used to investigate the relationships of each parameter. The most sensitive parameters for differentiating the control group from the PPG group by using Pulsar, OCT, and OCTA were square loss variance of PP (AUC = 0.673, p < 0.001), superior ganglion cell complex thickness (AUC = 0.860, p < 0.001), and superior-hemi retina thickness (AUC = 0.817, p < 0.001). In the PG group, the most sensitive parameters were mean defect of PP (AUC = 0.885, p < 0.001), whole image of ganglion cell complex thickness (AUC = 0.847, p < 0.001), and perifoveal retina thickness (AUC = 0.833, p < 0.001). The mean defect of PP was significantly correlated with vascular parameters (radial peripapillary capillary (RPC), p = 0.008; vessel density of macular superficial vascular complex (VDms), p = 0.001; vessel density of macular deep vascular complex (VDmd), p = 0.002). In conclusion, structural measurements using OCT were more sensitive than vascular measurements of OCTA and functional measurements of PP for PPG, while PP was more sensitive than the structural and vascular measurements for PG. The mean defect of PP was also shown to be highly correlated with the reduction of vessel density.
Collapse
|
39
|
Lin F, Qiu Z, Li F, Chen Y, Peng Y, Chen M, Song Y, Xiong J, Cheng W, Liu Y, Tan M, Zhang X, Weinreb R. Macular and submacular choroidal microvasculature in patients with primary open-angle glaucoma and high myopia. Br J Ophthalmol 2021; 107:650-656. [PMID: 34893473 DOI: 10.1136/bjophthalmol-2021-319557] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 11/21/2021] [Indexed: 11/03/2022]
Abstract
AIMS To characterise the influence of primary open-angle glaucoma (POAG) and high myopia (HM) on the macular and choroidal capillary density (CD). METHODS Two hundred and seven eyes were enrolled, including 80 POAG without HM, 50 POAG with HM, 31 HM without POAG and 46 normal controls. A fovea-centred 6×6 mm optical coherence tomography angiography scan was performed to obtain the CD of the superficial capillary plexus (SCP), deep capillary plexus (DCP) and choriocapillaris. Macular and choroidal CDs were compared among the groups and the association of CDs with visual field mean deviation (MD) was determined using linear regression models. RESULTS Compared with normal eyes, SCP CD was decreased in the POAG without HM group (p<0.05), while DCP CD was significantly decreased in the HM without POAG group (p<0.05). Both SCP and DCP CDs were significantly decreased in the POAG with HM group (p<0.05). CD reduction occurred mainly in the outer rather than inner ring of the 6×6 mm scan size. In multivariate regression analysis, worse MD was associated with lower CD in the outer ring of the SCP in all the HM eyes (p<0.05). CONCLUSIONS POAG and HM reduced macular CD in different layers of the retinal capillary plexus and both particularly in the outer ring of the 6×6 mm scans. Furthermore, assessment of the CD in the outer ring of the SCP may facilitate the diagnosis of glaucoma in eyes with HM.
Collapse
Affiliation(s)
- Fengbin Lin
- Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Zhen Qiu
- School of Software Engineering, South China University of Technology, Guangzhou, China
| | - Fei Li
- Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Yu Chen
- Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Yuying Peng
- Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Meiling Chen
- Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Yunhe Song
- Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Jian Xiong
- Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Weijing Cheng
- Clinical Research Center for Ophthalmology, Sun Yat-Sen University Zhongshan Ophthalmic Center, Guangzhou, China
| | - Yuhong Liu
- Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Mingkui Tan
- School of Software Engineering, South China University of Technology, Guangzhou, China
| | - Xiulan Zhang
- Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Robert Weinreb
- Hamilton Glaucoma Center and Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, California, USA
| |
Collapse
|
40
|
Ko CK, Huang KI, Su FY, Ko ML. Vessel Density in the Macular and Peripapillary Areas in Preperimetric Glaucoma to Various Stages of Primary Open-Angle Glaucoma in Taiwan. J Clin Med 2021; 10:jcm10235490. [PMID: 34884191 PMCID: PMC8658219 DOI: 10.3390/jcm10235490] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 11/21/2021] [Accepted: 11/22/2021] [Indexed: 01/19/2023] Open
Abstract
Peripapillary and macular vessel density (VD) are reduced in myopic non-glaucomatous eyes, the dynamic range of VD may be decreased by myopia, and whether VD measurement has the potential in differentiating stages of glaucoma severity in patients with myopic glaucoma remains questionable. This observational, cross-sectional study aimed to clarify the changes in peripapillary and macular VDs in preperimetric glaucoma (PPG) and primary open-angle glaucoma in the early, moderate, and late stages. A total of 1228 eyes from 661 participants (540 normal, 67 PPG, and 521 glaucomatous) were included. Participants underwent free blood tests at the internal medicine clinic to retrieve systemic data. Patients with glaucoma were grouped by disease severity, defined by glaucomatous visual field mean defect, including early-(224 eyes), moderate-(103 eyes), and late-stage glaucoma (194 eyes), and further divided into advanced (158 eyes) and terminal glaucoma (36 eyes). Macular VD, peripapillary VD, circumpapillary retinal nerve fiber layer (cpRNFL) thickness, and ganglion cell complex (GCC) thickness were evaluated and divided into superior and inferior parts. One-way analysis of variance was performed, followed by Tukey’s post-hoc test. The peripapillary VD was significantly different between the healthy and PPG groups and the early-, moderate-, and late-stage glaucoma subgroups (all p < 0.001). Peripapillary VD measurements are helpful in differentiating the various stages of glaucoma even in patients with myopic glaucoma.
Collapse
Affiliation(s)
- Chung-Kuang Ko
- Department of Neurology, China Medical University Hospital, Taichung 404, Taiwan;
| | - Kuan-I Huang
- Department of Ophthalmology, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei 111, Taiwan;
| | - Fang-Ying Su
- Institute of Statistics, National Chiao Tung University, Hsinchu 300, Taiwan;
| | - Mei-Lan Ko
- Department of Ophthalmology, National Taiwan University Hospital, Hsinchu 300, Taiwan
- Biomedical Engineering and Environmental Sciences, National Tsing Hua University, Hsinchu 300, Taiwan
- Correspondence: ; Tel.: +886-965-580-725
| |
Collapse
|
41
|
Combined wide-field optical coherence tomography angiography density map for high myopic glaucoma detection. Sci Rep 2021; 11:22034. [PMID: 34764370 PMCID: PMC8585951 DOI: 10.1038/s41598-021-01661-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 11/01/2021] [Indexed: 02/01/2023] Open
Abstract
The present study aimed to evaluate the diagnostic ability of wide-field optical coherence tomography angiography (OCTA) density map for detection of glaucomatous damage in high myopic (HM) eyes and to further compare the diagnostic ability of OCTA with that of conventional imaging approaches including red-free photography and swept-source OCT (SS-OCT) wide-field maps. A total of 77 healthy HM eyes and 72 HM eyes with open angle glaucoma (OAG) participated in this retrospective observational study. Patients underwent a comprehensive ocular examination, including wide-field SS-OCT scan and peripapillary area and macular OCTA scans. An integrated OCTA density map thereafter was merged by vascular landmark-guided superimposition of peripapillary and macular superficial vascular density maps onto the red-free photography (resulting in the OCTA-PanoMap). Glaucoma specialists then determined the presence of glaucomatous damage in HM eyes by reading the OCTA-PanoMap and compared its sensitivity and specificity with those of conventional images. Sensitivity and specificity of OCTA-PanoMap for HM-OAG diagnosis was 94.4% and 96.1%, respectively. Compared with other imaging methods, the sensitivity of OCTA-PanoMap was significantly higher than that of red-free photography (P = 0.022) and comparable to that of wide-field SS-OCT maps. Specificity of OCTA-PanoMap was significantly higher than those of other conventional imaging methods (except for wide-field thickness map). The OCTA-PanoMap showed good diagnostic ability for discrimination of HM-OAG eyes from healthy HM eyes. As a complementary method of an alternative imaging modality, OCTA-PanoMap can be a useful tool for detection of HM-OAG.
Collapse
|
42
|
Kamalipour A, Moghimi S, Jacoba CM, Yarmohammadi A, Yeh K, Proudfoot JA, Hou H, Nishida T, David RC, Rezapour J, El-Nimri N, Weinreb RN. Measurements of OCT Angiography Complement OCT for Diagnosing Early Primary Open-Angle Glaucoma. Ophthalmol Glaucoma 2021; 5:262-274. [PMID: 34634501 DOI: 10.1016/j.ogla.2021.09.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 09/01/2021] [Accepted: 09/29/2021] [Indexed: 11/16/2022]
Abstract
PURPOSE To compare measurements of global and regional circumpapillary capillary density (cpCD) with retinal nerve fiber layer (RNFL) thickness and characterize their relationship with visual function in early primary open-angle glaucoma (POAG). DESIGN Cross-sectional study. PARTICIPANTS Eighty healthy eyes, 64 preperimetric eyes, and 184 mild POAG eyes from the Diagnostic Innovations in Glaucoma Study. METHODS Global and regional RNFL thickness and cpCD measurements were obtained using OCT and OCT angiography (OCTA). For direct comparison at the individual and diagnostic group level, RNFL thickness and capillary density values were converted to a normalized relative loss scale. MAIN OUTCOME MEASURES Retinal nerve fiber layer thickness and cpCD normalized loss at the individual level and diagnostic group. Global and regional areas under the receiver operating characteristic curve (AUROC) for RNFL thickness and cpCD to detect preperimetric glaucoma and glaucoma, R2 for the strength of associations between RNFL thickness function and capillary density function in diagnostic groups. RESULTS Both global and regional RNFL thickness and cpCD decreased progressively with increasing glaucoma severity (P < 0.05, except for temporal RNFL thickness). Global and regional cpCD relative loss values were higher than those of RNFL thickness (P < 0.05) in preperimetric glaucoma (except for the superonasal region) and glaucoma (except for the inferonasal and superonasal regions) eyes. Race, intraocular pressure (IOP), and cpCD were associated with greater cpCD than RNFL thickness loss in early glaucoma at the individual level (P < 0.05). Global measurements of capillary density (whole image capillary density and cpCD) had higher diagnostic accuracies than RNFL thickness in detecting preperimetric glaucoma and glaucoma (P < 0.05; except for cpCD/RNFL thickness comparison in glaucoma [P = 0.059]). Visual function was significantly associated with RNFL thickness and cpCD globally and in all regions (P < 0.05, except for temporal RNFL thickness-function association [P = 0.070]). CONCLUSIONS Associations between capillary density and visual function were found in the regions known to be at highest risk for damage in preperimetric glaucoma eyes and all regions of mild glaucoma eyes. In early glaucoma, capillary density loss was more pronounced than RNFL thickness loss. Individual characteristics influence the relative magnitudes of capillary density loss compared with RNFL thickness loss. Retinal nerve fiber layer thickness and microvascular assessments are complementary and yield valuable information for the detection of early damages seen in POAG.
Collapse
Affiliation(s)
- Alireza Kamalipour
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California
| | - Sasan Moghimi
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California
| | - Cris Martin Jacoba
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California
| | - Adeleh Yarmohammadi
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California
| | - Kaileen Yeh
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California
| | - James A Proudfoot
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California
| | - Huiyuan Hou
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California
| | - Takashi Nishida
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California
| | - Ryan Caezar David
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California
| | - Jasmin Rezapour
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California
| | - Nevin El-Nimri
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California
| | - Robert N Weinreb
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California.
| |
Collapse
|
43
|
Abstract
Early detection and monitoring are critical to the diagnosis and management of glaucoma, a progressive optic neuropathy that causes irreversible blindness. Optical coherence tomography (OCT) has become a commonly utilized imaging modality that aids in the detection and monitoring of structural glaucomatous damage. Since its inception in 1991, OCT has progressed through multiple iterations, from time-domain OCT, to spectral-domain OCT, to swept-source OCT, all of which have progressively improved the resolution and speed of scans. Even newer technological advancements and OCT applications, such as adaptive optics, visible-light OCT, and OCT-angiography, have enriched the use of OCT in the evaluation of glaucoma. This article reviews current commercial and state-of-the-art OCT technologies and analytic techniques in the context of their utility for glaucoma diagnosis and management, as well as promising future directions. Expected final online publication date for the Annual Review of Vision Science, Volume 7 is September 2021. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
Collapse
Affiliation(s)
- Alexi Geevarghese
- Department of Ophthalmology, NYU Langone Health, NYU Grossman School of Medicine, New York, NY 10016, USA;
| | - Gadi Wollstein
- Department of Ophthalmology, NYU Langone Health, NYU Grossman School of Medicine, New York, NY 10016, USA; .,Department of Biomedical Engineering, NYU Tandon School of Engineering, Brooklyn, New York 11201, USA.,Center for Neural Science, NYU College of Arts and Sciences, New York, NY 10003, USA
| | - Hiroshi Ishikawa
- Department of Ophthalmology, NYU Langone Health, NYU Grossman School of Medicine, New York, NY 10016, USA; .,Department of Biomedical Engineering, NYU Tandon School of Engineering, Brooklyn, New York 11201, USA
| | - Joel S Schuman
- Department of Ophthalmology, NYU Langone Health, NYU Grossman School of Medicine, New York, NY 10016, USA; .,Department of Biomedical Engineering, NYU Tandon School of Engineering, Brooklyn, New York 11201, USA.,Center for Neural Science, NYU College of Arts and Sciences, New York, NY 10003, USA.,Department of Physiology and Neuroscience, NYU Langone Health, NYU Grossman School of Medicine, New York, NY 10016, USA
| |
Collapse
|
44
|
Tong Y, Wang T, Zhang X, He Y, Jiang B. Optical Coherence Tomography Evaluation of Peripapillary and Macular Structure Changes in Pre-perimetric Glaucoma, Early Perimetric Glaucoma, and Ocular Hypertension: A Systematic Review and Meta-Analysis. Front Med (Lausanne) 2021; 8:696004. [PMID: 34277670 PMCID: PMC8280320 DOI: 10.3389/fmed.2021.696004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 05/28/2021] [Indexed: 01/17/2023] Open
Abstract
Background: This study aimed to assess the differences in the average and sectoral peripapillary retinal nerve fiber layer (pRNFL), macular ganglion cell plus inner plexiform layer (mGCIPL), and macular ganglion cell complex (mGCC) thickness using optical coherence tomography (OCT) in patients with pre-perimetric glaucoma (PPG) compared to those with early perimetric glaucoma (EG) and ocular hypertension (OHT). Methods: A comprehensive literature search of the PubMed database, the Cochrane Library, and Embase was performed from inception to March 2021. The weighted mean difference (WMD) with the 95% confidence interval (CI) was pooled for continuous outcomes. Results: Twenty-three cross-sectional studies comprising 2,574 eyes (1,101 PPG eyes, 1,233 EG eyes, and 240 OHT eyes) were included in the systematic review and meta-analysis. The pooled results demonstrated that the average pRNFL (WMD = 8.22, 95% CI = 6.32–10.12, P < 0.00001), mGCIPL (WMD = 4.83, 95% CI = 3.43–6.23, P < 0.00001), and mGCC (WMD = 7.19, 95% CI = 4.52–9.85, P < 0.00001) were significantly thinner in patients with EG than in those with PPG. The sectoral thickness of pRNFL, mGCIPL, and mGCC were also significantly lower in the EG eyes. In addition, the average pRNFL and mGCC were significantly thinner in the PPG eyes than those in the OHT eyes (pRNFL: WMD = −8.57, 95% CI = −9.88 to −7.27, P < 0.00001; mGCC: WMD = −3.23, 95% CI = −6.03 to −0.44, P = 0.02). Similarly, the sectoral pRNFL and mGCC were also significantly thinner in the PPG eyes than those in the OHT eyes. Conclusion: OCT-based measurements of peripapillary and macular structural alterations can be used to distinguish PPG from EG and OHT, which can help understand the pathophysiology of glaucoma at earlier stages. Studies that employ clock hour classification methods and longitudinal studies are needed to verify our findings. Systematic Review Registration:https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=239798 CRD42021239798
Collapse
Affiliation(s)
- Yuxin Tong
- Department of Ophthalmology, Second Xiangya Hospital, Central South University, Changsha, China.,Hunan Clinical Research Center of Ophthalmic Disease, Changsha, China
| | - Tiantian Wang
- Department of Ophthalmology, Xiangya Hospital, Central South University, Changsha, China
| | - Xinyu Zhang
- Department of Ophthalmology, Second Xiangya Hospital, Central South University, Changsha, China.,Hunan Clinical Research Center of Ophthalmic Disease, Changsha, China
| | - Yi He
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, China
| | - Bing Jiang
- Department of Ophthalmology, Second Xiangya Hospital, Central South University, Changsha, China.,Hunan Clinical Research Center of Ophthalmic Disease, Changsha, China
| |
Collapse
|
45
|
You QS, Tan O, Pi S, Liu L, Wei P, Chen A, Ing E, Jia Y, Huang D. Effect of algorithms and covariates in glaucoma diagnosis with optical coherence tomography angiography. Br J Ophthalmol 2021; 106:1703-1709. [PMID: 34183324 DOI: 10.1136/bjophthalmol-2020-318677] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 06/11/2021] [Indexed: 11/04/2022]
Abstract
PURPOSE To assess the effects of algorithms and covariates in glaucoma diagnosis with optical coherence tomography angiography (OCTA). METHODS In this prospective cross-sectional study, one eye each of 36 normal controls and 64 patients with glaucoma underwent 4.5 mm disc-centred and 6 mm macula-centred OCTA scans. The peripapillary nerve fibre layer plexus capillary density (NFLP-CD) and macular superficial vascular complex vessel density (SVC-VD) were measured using both a commercial algorithm (AngioAnalytics) and a custom algorithm (Center for Ophthalmic Optics & Lasers Angiography Reading Toolkit (COOL-ART)). The nerve fibre layer and ganglion cell complex thicknesses were measured on structural OCT. RESULTS The overall peripapillary NFLP-CD and macular SVC-VD measured with the two algorithms were highly correlated but poorly agreed. Among the normal controls, the perfusion measurements made by both algorithms were significantly correlated with age. AngioAnalytics measurements were also correlated with signal strength index, while COOL-ART measurements were not. These covariates were adjusted. The diagnostic accuracy, measured as the area under the receiver operating characteristic curve for glaucoma detection, was not significantly different between algorithms, between structural and perfusion parameters and between the peripapillary and macular regions (All p>0.05). The macular SVC-VD in the 6 mm square had a significantly higher diagnostic accuracy than that of the central 3 mm square area (p=0.005). CONCLUSIONS AngioAnalytics and COOL-ART vessel density measurements are not interchangeable but potentially interconvertible. Age and signal strength are significant covariates that need to be considered. Both algorithms and both peripapillary and macular perfusion parameters have similarly good diagnostic accuracy comparable to structural OCT. A larger macular analytic area provides higher diagnostic accuracy.
Collapse
Affiliation(s)
- Qi Sheng You
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, USA
| | - Ou Tan
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, USA
| | - Shaohua Pi
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, USA
| | - Liang Liu
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, USA
| | - Ping Wei
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, USA
| | - Aiyin Chen
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, USA
| | - Eliesa Ing
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, USA
| | - Yali Jia
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, USA
| | - David Huang
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, USA
| |
Collapse
|
46
|
Enhanced Visualization of Retinal Microvasculature via Deep Learning on OCTA Image Quality. DISEASE MARKERS 2021; 2021:1373362. [PMID: 34221184 PMCID: PMC8221851 DOI: 10.1155/2021/1373362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Accepted: 06/07/2021] [Indexed: 11/17/2022]
Abstract
Purpose To investigate the impact of denoising on the qualitative and quantitative parameters of optical coherence tomography angiography (OCTA) images of the optic nerve and macular area. Methods OCTA images of the optic nerve and macular area were obtained using a Canon-HS100 OCT device for 48 participants (48 eyes). Multiple image averaging (MIA) and denoising techniques were used to improve the quality of the OCTA images. The peak signal-to-noise ratio (PSNR) as an image quality parameter and vessel density (VD) as a quantitative parameter were obtained from single-scan, MIA, and denoised OCTA images. The parameters were compared, and the correlation was analyzed between different imaging protocols. Results In the optic nerve area, there were significant differences in the PSNR and VD in all measured regions between the three groups (P < 0.0001). The PSNR of the denoised group was significantly higher than that of the other two groups (P < 0.0001). The VD in the denoised group was significantly lower than that in the single-scan group in all measured regions (P < 0.0001). In the macular area, there were significant differences in the PSNR and VD in all measured regions among the three groups. The PSNR of the denoised group was significantly higher than that of the other two groups (P < 0.0001). The VD in the denoised group was significantly lower than that in the single-scan group in all measured regions. The VD around the optic nerve in the denoised group was correlated with that in the single-scan group (R = 0.9403, P < 0.0001), but the VD in the MIA group was not correlated with that in the single-scan group (R = 0.2505, P = 0.2076). The VD around the fovea in the denoised and MIA images was correlated with that in the single-scan group (R = 0.7377, P < 0.0001; R = 0.7005, P = 0.0004, respectively). Conclusion Denoising could provide an easy and quick way to improve image quality parameters, such as PSNR. It shows great potential in improving the sensitivity of OCTA images as retinal disease markers.
Collapse
|
47
|
Lin F, Li F, Gao K, He W, Zeng J, Chen Y, Chen M, Cheng W, Song Y, Peng Y, Jin L, Lin TPH, Wang Y, Tham CC, Cheung CY, Zhang X. Longitudinal Changes in Macular Optical Coherence Tomography Angiography Metrics in Primary Open-Angle Glaucoma With High Myopia: A Prospective Study. Invest Ophthalmol Vis Sci 2021; 62:30. [PMID: 33507229 PMCID: PMC7846949 DOI: 10.1167/iovs.62.1.30] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Purpose To characterize longitudinal changes in macular microvasculature as quantified from optical coherence tomography angiography (OCTA) metrics in primary open-angle glaucoma (POAG) eyes with and without high myopia. Methods In total, 63 and 61 POAG eyes with and without high myopia, respectively, underwent swept-source OCTA imaging in at least four follow-up visits at an ophthalmic center, with a scanning protocol of 3- × 3-mm centered at the fovea. The foveal avascular zone (FAZ) area, FAZ circularity, and vessel density (VD) in both the superficial (SCP) and deep capillary plexuses (DCP) were measured. The rate of change in macular OCTA metrics over time was estimated using linear mixed-effects models in both groups of POAG eyes. Results The mean follow-up time and number of visits were 27.72 ± 8.57 months and 8.5 (8 to 13) times, and 30.95 ± 10.19 months and 10 (8‒13) times in POAG eyes with and without high myopia, respectively. VD in the DCP reduced significantly more quickly in POAG eyes with high myopia than in those without high myopia (−5.14%/year vs. −3.71%/year, P = 0.008). Moreover, lower baseline VD in the DCP was significantly associated with faster VD reduction in POAG with high myopia eyes (P < 0.001). Conversely, the VD reduction rate in the SCP, FAZ area, and FAZ circularity in both the SCP and DCP were similar in both groups (all Ps > 0.05). Conclusions VD in DCP reduced significantly more quickly in POAG eyes with high myopia over time. Density in the DCP reduced more quickly when baseline VD was low.
Collapse
Affiliation(s)
- Fengbin Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Fei Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Kai Gao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Wanbing He
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Jun Zeng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Yu Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Meiling Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Weijing Cheng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Yunhe Song
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Yuying Peng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Ling Jin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Timothy P H Lin
- Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Yumeng Wang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Clement C Tham
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Carol Y Cheung
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Xiulan Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| |
Collapse
|
48
|
The role of pattern electroretinograms and optical coherence tomography angiography in the diagnosis of normal-tension glaucoma. Sci Rep 2021; 11:12257. [PMID: 34112913 PMCID: PMC8192937 DOI: 10.1038/s41598-021-91813-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 05/26/2021] [Indexed: 12/28/2022] Open
Abstract
In this study, we investigated the correlation between pattern electroretinogram (PERG) and optical coherence tomography angiography (OCTA) parameters for diagnosis in patients with normal-tension glaucoma (NTG). Forty-nine normal individuals (49 eyes) and 60 patients with NTG (60 eyes) were enrolled. OCTA and PERG parameters, such as macular vessel density (VD) and the amplitude of N35–P50 and P50–N95, were measured. Correlation analyses were performed between the parameters, and the area under the curve (AUC) was used to identify their diagnostic ability for NTG. Macular VD and the amplitude of N35–P50 and P50–N95 showed significant differences between the normal individuals and patients with NTG. Correlation between P50 and N95 amplitude and macular VD was significant in the normal and early glaucoma groups. Macular VD showed a higher AUC value (0.730) than that of P50–N95 amplitude (0.645) in the early glaucoma group. In the moderate to severe glaucoma group, the AUC value of the amplitude of P50–N95 (0.907) was higher than that of macular VD (0.876). The results indicate that PERG and OCTA parameters may identify glaucoma in its early stage, based on the severity of glaucomatous damage in patients with NTG.
Collapse
|
49
|
Nie L, Xu J, Fu L, Ye Y, Chan YK, Li T, Pan W, Lu P. Changes in circumpapillary retinal vessel density after acute primary angle closure episode via OCT angiography. Int Ophthalmol 2021; 41:2389-2397. [PMID: 33948808 DOI: 10.1007/s10792-021-01793-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Accepted: 03/06/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE To investigate the changes and evaluate the diagnosis value of circumpapillary vessel density (VD) in cases of acute primary angle closure (APAC). DESIGN Case-control study. METHODS APAC patients with a history of unilateral acute attack were enrolled. The eyes with acute episode constituted the case group while the contralateral eyes without attack consisted of the control group. Ophthalmic examinations including slit-lamp examination, best-corrected visual acuity, intraocular pressure and visual field were carried out. Retinal nerve fiber layer (RNFL), macular ganglion cell complex (GCC) were measured by spectral-domain optical coherence tomography, while VD was assessed by optical coherence tomography angiography. RESULTS The whole en face image vessel density (wiVD), circumpapillary vessel density (cpVD) and inside disk VD for both all vessels and capillary were all significantly lower in the APAC eyes compared to the fellow eyes (P < 0.01 for all). In APAC eyes, the wiVD, inside disk VD and cpVD both for all vessels and capillary were all positively correlated with RNFL and GCC thicknesses but negatively correlated with the mean deviation (MD), pattern standard deviation (PSD) and the duration of acute attack (all P < 0.01). From the ROC curve, the cpVDcap, wiVDcap, cpVDall and wiVDall all showed comparable diagnostic ability with RNFL, GCC and MD to differentiate eyes with APAC from the fellow eyes (all P > 0.05). The inside disk VDcap and VDall demonstrated significant lower diagnostic ability than the cpVDcap, wiVDcap, cpVDall and wiVDall (all P < 0.001). CONCLUSIONS In APAC eyes, circumpapillary VD decreased significantly compared with the fellow unaffected eyes. They were significantly correlated with thicknesses of RNFL and GCC, and visual field MD and PSD in the APAC eyes. The patients with longer duration of acute attack were more likely to have lower cpVD. For APAC, the diagnostic ability of wiVD and cpVD was similar with RNFL, GCC and MD and was higher than inside disk VD.
Collapse
Affiliation(s)
- Li Nie
- Department of Ophthalmology, The First Affiliated Hospital of Soochow University, Suzhou, 215006, Jiangsu, China.,Department of Glaucoma, Affiliated Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Hangzhou, 310000, Zhejiang, China
| | - Jiawen Xu
- Department of Glaucoma, Affiliated Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Hangzhou, 310000, Zhejiang, China
| | - Lin Fu
- Department of Glaucoma, Affiliated Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Hangzhou, 310000, Zhejiang, China
| | - Yufeng Ye
- Department of Glaucoma, Affiliated Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Hangzhou, 310000, Zhejiang, China
| | - Yau Kei Chan
- Department of Ophthalmology, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Tiankun Li
- Department of Glaucoma, Affiliated Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Hangzhou, 310000, Zhejiang, China
| | - Weihua Pan
- Department of Glaucoma, Affiliated Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Hangzhou, 310000, Zhejiang, China
| | - Peirong Lu
- Department of Ophthalmology, The First Affiliated Hospital of Soochow University, Suzhou, 215006, Jiangsu, China.
| |
Collapse
|
50
|
Quantitative assessment of retinal thickness and vessel density using optical coherence tomography angiography in patients with Alzheimer's disease and glaucoma. PLoS One 2021; 16:e0248284. [PMID: 33739997 PMCID: PMC7978346 DOI: 10.1371/journal.pone.0248284] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 02/23/2021] [Indexed: 12/18/2022] Open
Abstract
Purpose Assessment and a direct comparison of retinal vessel density with the thickness of inner retinal layer (IRL) and outer retinal layer (ORL) in the same regions of the macula in subjects with Alzheimer’s disease (AD) and primary open-angle glaucoma (POAG). Methods We analyzed data from 48 eyes of healthy control (HC) participants, 71 eyes with POAG, and 49 eyes of AD patients. Ophthalmic examination included optical coherence tomography (OCT) imaging to measure IRL and ORL thickness and OCT angiography (OCTA) in the same region for the imaging of vessel density in the superficial vascular plexus (SVP) and deep vascular plexus (DVP) of the retina. A direct comparison of vessel density and retinal layers thickness, which different dynamic ranges, was obtained by normalizing values as percentage losses. Results Patients with AD presented significantly greater losses of vascular density in the DVP and ORL thickness compared to POAG (p <0.001), but percentage losses of vessel density in SVP and IRL thickness were considerable in POAG compared to AD eyes (p<0.001). Positive associations among presence of AD were observed primarily in outer retina where a 1% decrease of ORL thickness was associated with about 24–29% increase in odds of the presence of AD. According to OCTA measurements, a 1% decrease of vessel density in DVP was positively associated with a 4–9% increase in odds of the presence of AD. In POAG positive associations among presence of disease were observed only in inner retina where 1% loss of IRL thickness and a 1% loss of vessel density in the SVP were positively associated with a 13–23% increase in risk of presence of the disease. Conclusions Analysis of ORL thickness and vessel density in DVP could potentially improve diagnostic capabilities and may provide a valuable approach for predicting of AD.
Collapse
|