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Çomçalı S, Yılmaz PT, Köz ÖG, Coşkun Ç, Çavdarlı C, Güvenç H, Yarangümeli A, Özdemir EY. Comparison of the vessel density measurements of the macula, optical disc, and peri-papillary region between ocular hypertension patients and healthy controls. Photodiagnosis Photodyn Ther 2023; 42:103551. [PMID: 37011719 DOI: 10.1016/j.pdpdt.2023.103551] [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: 01/11/2023] [Revised: 03/11/2023] [Accepted: 03/31/2023] [Indexed: 04/03/2023]
Abstract
OBJECTIVE To evaluate Optical Coherence Tomography Angiography (OCT-A) findings in patients with Ocular Hypertension (OHT) and compare them with healthy individuals. METHODS Thirty-four patients with ocular hypertension (OHT) and 22 healthy individuals were included in the study. Foveal thickness, retinal vascular density in superficial and deep capillary plexus and choriocapillaris, foveal avascular zone (FAZ), acircularity index (AI), foveal vessel density (FD), non-flow area, capillary and all vessel densities in the peripapillary area and the disc were automatically measured using the Angiovue software of OCT-A and compared between groups. RESULTS The comparison of the macular OCT-A findings did not reveal a significant difference between the two groups in terms of central macular thickness, superficial and deep capillary plexus vessel density (p>0.05). The foveal avascular zone width was significantly higher in OHT subjects compared to the control group (0.30±0.08 µ and 0.25±0.11 µ, respectively; p = 0.04). The comparison of optic nerve OCT-A findings revealed that the whole-field vessel density (wVD) (p = 0.007), peripapillary vessel density (pVD) (p = 0.001), inferior, superior and temporal radial peripapillary capillary plexus vessel density (p = 0.006, p = 0.008, p = 0.02) and the mean retinal nerve fiber layer thickness (p = 0.02) were significantly lower in the OHT group. CONCLUSIONS Our findings suggest that the decrement in the optic disc vascular density and foveal avascular zone width was significantly higher in OHT subjects. The possible effect or role of these microvascular changes in terms of glaucoma development should be examined through further studies.
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Affiliation(s)
- Sebile Çomçalı
- Department of Ophthalmology, Ankara City Hospital, Ankara, Turkey.
| | | | - Özlem Gürbüz Köz
- Department of Ophthalmology, Ankara City Hospital, Ankara, Turkey
| | - Çiğdem Coşkun
- Department of Ophthalmology, Ankara City Hospital, Ankara, Turkey
| | - Cemal Çavdarlı
- Department of Ophthalmology, Ankara City Hospital, Ankara, Turkey
| | - Hülya Güvenç
- Department of Ophthalmology, Ankara City Hospital, Ankara, Turkey
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Kurysheva NI, Nikitina AD. [Optical coherence tomography and optical coherence tomography angiography for detecting glaucoma progression. Part 1. Study methods, measurement variability and the role of age-related changes]. Vestn Oftalmol 2023; 139:122-128. [PMID: 36924524 DOI: 10.17116/oftalma2023139011122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
This paper reviews the literature on the role of optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) in the diagnosis of glaucoma and considers the significance of evaluating retinal nerve fiber layer and ganglion cell complex in assessment of glaucoma progression, variability and reproducibility of the method, as well as the influence of age-related retinal changes on the results, analyzes the role of OCTA in glaucoma monitoring. Optical coherence tomography is a modern standard for glaucoma diagnosis and monitoring, and OCTA shows high potential as an auxiliary diagnostic tool.
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Affiliation(s)
- N I Kurysheva
- Medical Biological University of Innovations and Continuing Education of the Federal Biophysical Center named after A.I. Burnazyan, Moscow, Russia.,Ophthalmological Center of the Federal Medical-Biological Agency - Federal Medical Biophysical Center named after A.I. Burnazyan, Moscow, Russia
| | - A D Nikitina
- Medical Biological University of Innovations and Continuing Education of the Federal Biophysical Center named after A.I. Burnazyan, Moscow, Russia.,Ophthalmological Center of the Federal Medical-Biological Agency - Federal Medical Biophysical Center named after A.I. Burnazyan, Moscow, Russia
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El-Nimri NW, Manalastas PIC, Zangwill LM, Proudfoot JA, Bowd C, Hou H, Moghimi S, Penteado RC, Rezapour J, Ekici E, Shoji T, Ghahari E, Yarmohammadi A, Weinreb RN. Superficial and Deep Macula Vessel Density in Healthy, Glaucoma Suspect, and Glaucoma Eyes. J Glaucoma 2021; 30:e276-e284. [PMID: 33899812 PMCID: PMC8169636 DOI: 10.1097/ijg.0000000000001860] [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: 12/21/2020] [Accepted: 03/16/2021] [Indexed: 11/27/2022]
Abstract
PRECIS Macular superficial capillary plexus (SCP) vessel density is more informative than deep capillary plexus (DCP) vessel density for the detection of glaucoma. PURPOSE The purpose of this study was to characterize optical coherence tomography angiography macular SCP and projection-resolved DCP vessel densities and compare their diagnostic accuracies with ganglion cell complex (GCC) thickness in healthy, glaucoma suspect, and glaucoma eyes. MATERIALS AND METHODS Sixty-eight eyes of 44 healthy subjects, 26 eyes of 16 preperimetric glaucoma suspects, and 161 eyes of 124 glaucoma patients from the Diagnostics Innovations in Glaucoma Study with good quality high-density 6×6 mm2 macula optical coherence tomography angiography images were included. The diagnostic accuracy of SCP vessel density, projection-resolved DCP vessel density and GCC thickness were compared among groups. RESULTS Mean whole image vessel density (wiVD; % of area occupied by vessels containing flowing blood) in the SCP layer was highest in healthy eyes (49.7%), followed by glaucoma suspect eyes (46.0%), and glaucoma eyes (40.9%) (P<0.001). Mean wiVD in the DCP layer was similar in healthy (50.6%), glaucoma suspect (47.3%), and glaucoma eyes (45.7%) (P=0.925). Diagnostic accuracy of both GCC thickness and SCP wiVD was significantly higher than DCP wiVD for classifying healthy and glaucoma eyes [adjusted area under the receiver operating characteristic curve (95% confidence interval): GCC=0.86 (0.72, 0.94), SCP=0.80 (0.66, 0.91) and DCP=0.44 (0.30, 0.57)] (P<0.001). CONCLUSIONS SCP vessel densities have better diagnostic accuracy for detecting glaucoma than DCP vessel densities. Although the diagnostic accuracy of the macula SCP is relatively modest, it is more informative than the DCP.
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Affiliation(s)
- Nevin W. El-Nimri
- Department of Ophthalmology, Hamilton Glaucoma Center, Shiley Eye Institute, University of California San Diego, San Diego, CA, United States
| | - Patricia Isabel C. Manalastas
- Department of Ophthalmology, Hamilton Glaucoma Center, Shiley Eye Institute, University of California San Diego, San Diego, CA, United States
| | - Linda M. Zangwill
- Department of Ophthalmology, Hamilton Glaucoma Center, Shiley Eye Institute, University of California San Diego, San Diego, CA, United States
| | - James A. Proudfoot
- Department of Ophthalmology, Hamilton Glaucoma Center, Shiley Eye Institute, University of California San Diego, San Diego, CA, United States
| | - Christopher Bowd
- Department of Ophthalmology, Hamilton Glaucoma Center, Shiley Eye Institute, University of California San Diego, San Diego, CA, United States
| | - Huiyuan Hou
- Department of Ophthalmology, Hamilton Glaucoma Center, Shiley Eye Institute, University of California San Diego, San Diego, CA, United States
| | - Sasan Moghimi
- Department of Ophthalmology, Hamilton Glaucoma Center, Shiley Eye Institute, University of California San Diego, San Diego, CA, United States
| | - Rafaella C. Penteado
- Department of Ophthalmology, Hamilton Glaucoma Center, Shiley Eye Institute, University of California San Diego, San Diego, CA, United States
| | - Jasmin Rezapour
- Department of Ophthalmology, Hamilton Glaucoma Center, Shiley Eye Institute, University of California San Diego, San Diego, CA, United States
| | - Eren Ekici
- Department of Ophthalmology, Hamilton Glaucoma Center, Shiley Eye Institute, University of California San Diego, San Diego, CA, United States
- Department of Ophthalmology, Ankara Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
| | - Takuhei Shoji
- Department of Ophthalmology, Hamilton Glaucoma Center, Shiley Eye Institute, University of California San Diego, San Diego, CA, United States
- Department of Ophthalmology, Saitama Medical University, Iruma, Saitama, Japan
| | - Elham Ghahari
- Department of Ophthalmology, Hamilton Glaucoma Center, Shiley Eye Institute, University of California San Diego, San Diego, CA, United States
- Department of Ophthalmology, University of Kentucky, Lexington, KY, United States
| | - Adeleh Yarmohammadi
- Department of Ophthalmology, Hamilton Glaucoma Center, Shiley Eye Institute, University of California San Diego, San Diego, CA, United States
| | - Robert N. Weinreb
- Department of Ophthalmology, Hamilton Glaucoma Center, Shiley Eye Institute, University of California San Diego, San Diego, CA, United States
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Köse HC, Tekeli O. Optical coherence tomography angiography of the peripapillary region and macula in normal, primary open angle glaucoma, pseudoexfoliation glaucoma and ocular hypertension eyes. Int J Ophthalmol 2020; 13:744-754. [PMID: 32420221 DOI: 10.18240/ijo.2020.05.08] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 10/25/2019] [Indexed: 02/07/2023] Open
Abstract
AIM To evaluate and compare the peripapillary and retinal vasculature changes in primary open angle glaucoma (POAG), pseudoexfoliation glaucoma (PXG), ocular hypertension (OHT) and normal eyes using optical coherence tomography angiography (OCTA). METHODS A total of 114 POAG, PXG and OHT eyes of 60 patients and 46 eyes of 23 healthy control participants with good quality OCTA images were included. The PXG, POAG, OHT, and control groups (aged 68.17±6.30y, 61.11±10.26y, 58.1±8.9y, and 56.9±4.6y, respectively) contained of 46, 36, 32, and 46 eyes, respectively. Measurements of vessel density (VD) in the peripapillary region and macula, average retinal inner thickness, and retinal nerve fiber layer thickness (RNFLT) were compared among groups. In order to test the accuracy of differentiation between eyes with and without glaucoma, the area was calculated under the receiver operating characteristic (ROC) curves. RESULTS The VD in glaucomatous eyes was significantly lower than the control group in all peripapillary sectors (44.35%±6.78% vs 50.47%±1.83%, P<0.001), the superficial (44.08%±5.46% vs 51.28%±2.85%, P<0.001) and the deep (45.13%±8.55% vs 54.20%±5.44%, P<0.001) vascular plexus. There was a significant difference in peripapillary VD between glaucomatous and OHT eyes (44.35%±6.78% vs 49.86%±2.45%, P<0.001). The OHT group featured a lower superficial (48.06%±4.32% vs 51.28%±2.85%, P=0.027) and deep plexus (48.70%±5.99% vs 54.20%±5.44%, P=0.013) whole image vessel density (wiVD) than did the control group. The average macular superficial plexus wiVD was significantly lower in eyes with PXG than in eyes with POAG (42.22%±5.36% vs 46.54%±5.56%, P=0.046). CONCLUSION OCTA can measure reduced peripapillary and macular VD in eyes with glaucoma and OHT, and these results are correlated to functional and structural glaucomatous alterations. Peripapillary and macular superficial plexus VD is lower in eyes with PXG than in eyes with POAG. Furthermore, the OHT eyes demonstrate impaired macular vasculature in both superficial and deep plexus.
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Affiliation(s)
- Helin Ceren Köse
- Department of Ophthalmology, Ankara University Faculty of Medicine, Ankara 06620, Turkey
| | - Oya Tekeli
- Department of Ophthalmology, Ankara University Faculty of Medicine, Ankara 06620, Turkey
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Hou H, Moghimi S, Proudfoot JA, Ghahari E, Penteado RC, Bowd C, Yang D, Weinreb RN. Ganglion Cell Complex Thickness and Macular Vessel Density Loss in Primary Open-Angle Glaucoma. Ophthalmology 2020; 127:1043-1052. [PMID: 32085875 DOI: 10.1016/j.ophtha.2019.12.030] [Citation(s) in RCA: 74] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 12/12/2019] [Accepted: 12/27/2019] [Indexed: 10/25/2022] Open
Abstract
PURPOSE To characterize the change rate of ganglion cell complex (GCC) thickness and macular vessel density in healthy, preperimetric glaucoma and primary open-angle glaucoma (POAG) eyes. DESIGN Prospective, longitudinal study. PARTICIPANTS One hundred thirty-nine eyes (23 healthy eyes, 36 preperimetric glaucoma eyes, and 80 POAG eyes) of 94 patients who had at least 3 visits were included from the Diagnostic Innovations in Glaucoma Study. The mean follow-up was 2.0 years for healthy eyes, 2.6 years for preperimetric glaucoma eyes, and 2.6 years for POAG eyes. METHODS OCT angiography (OCTA)-based vessel density and OCT-based structural thickness of the same 3×3-mm2 GCC scan slab were evaluated. The dynamic range-based normalized rates of vessel density and thickness change were calculated and compared within each diagnostic group. The association between the rates of thickness and vessel density change and potential factors were evaluated. MAIN OUTCOME MEASURES The rates of GCC thinning and macular vessel density loss. RESULTS Significant rates of GCC thinning and macular vessel density decrease were detectable in all diagnostic groups (all P < 0.05). In healthy eyes and preperimetric glaucoma eyes, the normalized rates of GCC thinning and macular vessel density decrease were comparable (all P > 0.1). In contrast, the normalized rate (mean, 95% confidence interval) of macular vessel density decrease in the POAG eyes (-7.12 [-8.36, -5.88]%/year) was significantly faster than GCC thinning (-2.13 [-3.35, -0.90]%/year; P < 0.001). In the POAG group, more than two thirds of the eyes showed faster macular vessel density decrease than GCC thinning; faster macular vessel density decrease rate was associated significantly with worse glaucoma severity (P = 0.037). The association between GCC thinning rate and glaucoma severity was not significant (P = 0.586). Intraocular pressure during follow-up significantly affected the rate of GCC thinning in all groups (all P < 0.05) but showed no association with the rate of macular vessel density decrease. CONCLUSIONS Both GCC thinning and macular vessel density decrease were detectable over time in all diagnostic groups. In POAG eyes, macular vessel density decrease was faster than GCC thinning and was associated with severity of disease. Macular vessel density is useful for evaluating glaucoma progression, particularly in more advanced disease.
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Affiliation(s)
- Huiyuan Hou
- Hamilton Glaucoma Center and Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California
| | - Sasan Moghimi
- Hamilton Glaucoma Center and Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California
| | - James A Proudfoot
- Hamilton Glaucoma Center and Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California
| | - Elham Ghahari
- Hamilton Glaucoma Center and Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California
| | - Rafaella C Penteado
- Hamilton Glaucoma Center and Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California; Department of Ophthalmology, University of São Paulo, São Paulo, Brazil
| | - Christopher Bowd
- Hamilton Glaucoma Center and Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California
| | - Diya Yang
- Hamilton Glaucoma Center and Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California
| | - Robert N Weinreb
- Hamilton Glaucoma Center and Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California.
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Ma ZW, Qiu WH, Zhou DN, Yang WH, Pan XF, Chen H. Changes in vessel density of the patients with narrow antenior chamber after an acute intraocular pressure elevation observed by OCT angiography. BMC Ophthalmol 2019; 19:132. [PMID: 31226955 PMCID: PMC6588906 DOI: 10.1186/s12886-019-1146-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 06/13/2019] [Indexed: 02/07/2023] Open
Abstract
Background Although the pathogenesis of glaucoma is not fully understood,an elevated intraocular pressure (IOP) is a major factor contributing to its development and progression. The aim of this study was to investigate the changes in the vessel densities of the macula and optic nerve head (ONH) after an acute elevation in the intraocular pressure (IOP) observed using optical coherence tomography angiography (OCTA). Methods This was a prospective comparative study of subjects with narrow anterior chamber angles who underwent laser peripheral iridotomies (LPIs). The IOP was measured before and one hour after the LPI. The retinal vessel densities of the macula and ONH were measured using OCTA at the baseline and one hour after the LPI. Results A total of 64 eyes of 51 individuals were enrolled in this study, and 58 eyes of 43 individuals finally completed the study with a mean IOP rise of 10.5 ± 7.6 mmHg after the LPI. Based on the magnitude of the rise in the IOP, we divided the subjects into three groups: group A = IOP rise ≤10 mmHg, group B = 10 mmHg < IOP rise ≤20 mmHg, and group C = IOP rise > 20 mmHg. The vessel density did not differ after the acute IOP elevation in either the macular region or papillary region in group A or group B (p > 0.05), but there was a significant difference in group C (p < 0.05). However, when the subjects were not separated into groups, the vessel densities of the ONH and macular region did not differ between the measurements obtained at the baseline and one hour after the LPI (p > 0.05). The correlation existed in peripapillary and macular vessel density (p < 0.05). Conclusion In these subjects with narrow antenior chamber, an acute mild or moderate IOP elevation for one hour after the LPI did not affect the vessel density in the macula or ONH, as examined using OCTA. However, when the IOP rise was greater than 20 mmHg, the macular and papillary vessel density decreased significantly.
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Affiliation(s)
- Zi-Wei Ma
- Department of Ophthalmology, The First People's Hospital of Huzhou, Huzhou, 313000, Zhejiang Province, China.
| | - Wen-Han Qiu
- Department of Ophthalmology, The First People's Hospital of Huzhou, Huzhou, 313000, Zhejiang Province, China
| | - Dan-Ni Zhou
- Department of Ophthalmology, The First People's Hospital of Huzhou, Huzhou, 313000, Zhejiang Province, China
| | - Wei-Hua Yang
- Department of Ophthalmology, The First People's Hospital of Huzhou, Huzhou, 313000, Zhejiang Province, China
| | - Xue-Feng Pan
- Department of Ophthalmology, The First People's Hospital of Huzhou, Huzhou, 313000, Zhejiang Province, China
| | - Hong Chen
- Department of Ophthalmology, The First People's Hospital of Huzhou, Huzhou, 313000, Zhejiang Province, China
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Hou H, Moghimi S, Zangwill LM, Shoji T, Ghahari E, Penteado RC, Akagi T, Manalastas PIC, Weinreb RN. Macula Vessel Density and Thickness in Early Primary Open-Angle Glaucoma. Am J Ophthalmol 2019; 199:120-132. [PMID: 30496723 DOI: 10.1016/j.ajo.2018.11.012] [Citation(s) in RCA: 81] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 10/23/2018] [Accepted: 11/16/2018] [Indexed: 12/20/2022]
Abstract
PURPOSE To characterize and compare the ganglion cell complex (GCC) thickness and macula vessel density in preperimetric and early primary open-angle glaucoma (POAG) eyes. DESIGN Cross-sectional study. METHODS Fifty-seven healthy, 68 preperimetric, and 162 early POAG eyes enrolled in the Diagnostic Innovations in Glaucoma Study. Optical coherence tomography angiography (OCT-A)-based superficial macula vessel density and OCT-based GCC thickness were evaluated simultaneously. Percent loss from normal of GCC thickness and macula vessel density was compared. Area under the receiver operating characteristic curve was used to describe the diagnostic utility. RESULTS Both GCC thickness and vessel density were significantly lower in preperimetric and early POAG eyes compared to healthy eyes. Compared to the preperimetric POAG group, the early POAG group showed larger GCC thickness percent loss (whole image 4.72% vs 9.86%; all P < .01) but similar vessel density percent loss (whole image 4.97% vs 6.93%; all P > .05). In preperimetric POAG, GCC thickness and vessel density percent losses were similar (all P > .1). In contrast, in early POAG, GCC thickness percent loss was larger than that of vessel density (all P ≤ .001). To discriminate preperimetric or early glaucoma eyes from healthy eyes, GCC thickness and macula vessel density showed similar diagnostic accuracy (all P > .05). CONCLUSIONS Both GCC thinning and macula vessel density dropout were detectable in preperimetric and early POAG eyes. GCC loss was greater than macula vessel density loss in early perimetric POAG. However, OCT-A and OCT measurements showed similar efficiency to detect early glaucoma.
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Affiliation(s)
- Huiyuan Hou
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, California, USA
| | - Sasan Moghimi
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, California, USA; Department of Ophthalmology, Tehran University of Medical Sciences, Tehran, Iran
| | - Linda M Zangwill
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, California, USA
| | - Takuhei Shoji
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, California, USA; Department of Ophthalmology, Saitama Medical University, Iruma, Saitama, Japan
| | - Elham Ghahari
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, California, USA
| | - Rafaella C Penteado
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, California, USA
| | - Tadamichi Akagi
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, California, USA; Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Patricia Isabel C Manalastas
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, California, USA
| | - Robert N Weinreb
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, California, USA.
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Abstract
PURPOSE To provide the reader with information on the principal techniques of optical coherence tomography angiography (OCTA); the current literature on OCTA reproducibility; its applications to glaucoma detection and monitoring of progression; and the role of OCTA in the assessment of the vascular component in glaucoma pathogenesis. METHODS A literature review of the pertinent publications for the OCTA in relation to the development, techniques, and its use in glaucoma was carried out. RESULTS Rapid improvements in optical coherence tomography (OCT) technology have allowed for enhancement of both image resolution and scanning speed, and the development of vascular assessment modality. OCTA is the non-invasive in vivo imaging of the vasculature located within the retina and optic nerve head area. The principle of OCTA is to use the variations in OCT signals caused by moving particles as the contrast mechanism for imaging of flow. Several algorithms which aim to maximize the contrast signal and minimize the noise have been developed including the phase-based techniques, intensity-based techniques (e.g., split-spectrum amplitude decorrelation angiography (SSADA)), and complex-based techniques (e.g., optical microangiography (OMAG)). With its reliable technique, high image resolution, and current availability, OCTA has been widely used in the assessment of posterior segment diseases including glaucoma in which ocular perfusion dysfunction has been proposed as a pathophysiological mechanism. CONCLUSION OCTA may enhance our knowledge of glaucoma pathogenesis and offer an improvement in our ability to detect glaucomatous change.
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Affiliation(s)
- Sunee Chansangpetch
- a Department of Ophthalmology , University of California San Francisco , San Francisco , CA , USA.,b Department of Ophthalmology , Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross , Bangkok , Thailand
| | - Shan C Lin
- a Department of Ophthalmology , University of California San Francisco , San Francisco , CA , USA
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Lommatzsch C, Rothaus K, Koch JM, Heinz C, Grisanti S. OCTA vessel density changes in the macular zone in glaucomatous eyes. Graefes Arch Clin Exp Ophthalmol 2018; 256:1499-1508. [PMID: 29637255 DOI: 10.1007/s00417-018-3965-1] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 02/19/2018] [Accepted: 03/23/2018] [Indexed: 12/12/2022] Open
Abstract
PURPOSE To evaluate whether macular optical coherence tomography angiography (OCTA) can detect altered vessel density (VD) in the superficial and deep vascular plexus in glaucomatous eyes and to compare the diagnostic utility of the individual VD parameters. METHODS The macular VD of 135 eyes, comprising 85 eyes diagnosed with glaucoma and 50 healthy control eyes, was examined using two OCTA devices (AngioPlex-Zeiss Meditec, Inc., Dublin, CA, USA, and AngioVue-OptoVue, Inc., Fremont, CA, USA). All study participants had neither vascular pathology, diabetes, nor vasoactive medication. The macular VD was measured at two different levels of segmentation (superficial [SL] and deep [DL] retinal vascular plexus) with a 6 × 6-mm macula scan, and VD was correlated with various structural and functional measurements. In order to test the accuracy of differentiation between eyes with and without glaucoma, we calculated the receiver operating characteristic (ROC) curve and the area under the curve (AUC). RESULTS Macular VD was significantly lower in both SL and DL in glaucomatous eyes than in healthy eyes (p = SL < 0.0001; DL = 0.009). There was no significant difference in VD between the SL and the DL (p = 6.60 · 10-18). The greatest reduction of VD in glaucomatous eyes was found in the inferior macular sector. There was no correlation of VD with age or refractive error but moderate to high correlation with intraocular pressure, time of initial diagnosis, mean deviation, ganglion cell complex, peripapillary retinal nerve fiber layer thickness, cup to disc ratio, and rim area. Among the 14 individual features of macular VD, whole VD in the SL had the best diagnostic accuracy (77.6%) as measured by the area under the ROC. CONCLUSION OCTA detects glaucomatous damage by measuring the macular vessel density in the superficial and deep retinal vascular plexus. It can be an additional diagnostic tool to detect glaucoma independently of the optic nerve.
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Affiliation(s)
- C Lommatzsch
- Department of Ophthalmology, St. Franziskus Hospital, Hohenzollernring 74, 48145, Muenster, Germany.
| | - K Rothaus
- Department of Ophthalmology, St. Franziskus Hospital, Hohenzollernring 74, 48145, Muenster, Germany
| | - J M Koch
- Department of Ophthalmology, St. Franziskus Hospital, Hohenzollernring 74, 48145, Muenster, Germany
| | - C Heinz
- Department of Ophthalmology, St. Franziskus Hospital, Hohenzollernring 74, 48145, Muenster, Germany.,Department of Ophthalmology, University of Essen, Essen, Germany
| | - S Grisanti
- Department of Ophthalmology, University of Luebeck, Luebeck, Germany
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