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Invest Ophthalmol Vis SciJuly 2016401 citations

Optical Coherence Tomography Angiography Vessel Density in Healthy, Glaucoma Suspect, and Glaucoma Eyes.

Yarmohammadi Adeleh, Zangwill Linda M, Diniz-Filho Alberto, Suh Min Hee, Manalastas Patricia Isabel, Fatehee Naeem, Yousefi Siamak, Belghith Akram, Saunders Luke J, Medeiros Felipe A


AI Summary

OCT-A vessel density effectively differentiated glaucoma from healthy eyes, showing similar diagnostic accuracy to RNFL thickness, suggesting its utility in assessing glaucoma-related tissue damage.

Abstract

Purpose

The purpose of this study was to compare retinal nerve fiber layer (RNFL) thickness and optical coherence tomography angiography (OCT-A) retinal vasculature measurements in healthy, glaucoma suspect, and glaucoma patients.

Methods

Two hundred sixty-one eyes of 164 healthy, glaucoma suspect, and open-angle glaucoma (OAG) participants from the Diagnostic Innovations in Glaucoma Study with good quality OCT-A images were included. Retinal vasculature information was summarized as a vessel density map and as vessel density (%), which is the proportion of flowing vessel area over the total area evaluated. Two vessel density measurements extracted from the RNFL were analyzed: (1) circumpapillary vessel density (cpVD) measured in a 750-μm-wide elliptical annulus around the disc and (2) whole image vessel density (wiVD) measured over the entire image. Areas under the receiver operating characteristic curves (AUROC) were used to evaluate diagnostic accuracy.

Results

Age-adjusted mean vessel density was significantly lower in OAG eyes compared with glaucoma suspects and healthy eyes. (cpVD: 55.1 ± 7%, 60.3 ± 5%, and 64.2 ± 3%, respectively; P < 0.001; and wiVD: 46.2 ± 6%, 51.3 ± 5%, and 56.6 ± 3%, respectively; P < 0.001). For differentiating between glaucoma and healthy eyes, the age-adjusted AUROC was highest for wiVD (0.94), followed by RNFL thickness (0.92) and cpVD (0.83). The AUROCs for differentiating between healthy and glaucoma suspect eyes were highest for wiVD (0.70), followed by cpVD (0.65) and RNFL thickness (0.65).

Conclusions

Optical coherence tomography angiography vessel density had similar diagnostic accuracy to RNFL thickness measurements for differentiating between healthy and glaucoma eyes. These results suggest that OCT-A measurements reflect damage to tissues relevant to the pathophysiology of OAG.


MeSH Terms

Fluorescein AngiographyFundus OculiGlaucomaGonioscopyHumansIntraocular PressureOptic DiskPerioperative CareReproducibility of ResultsRetinal Ganglion CellsRetinal VesselsTomography, Optical CoherenceVisual AcuityVisual Fields

Key Concepts5

In a cross-sectional study of 261 eyes from 164 healthy, glaucoma suspect, and open-angle glaucoma (OAG) participants, age-adjusted mean circumpapillary vessel density (cpVD) was significantly lower in OAG eyes (55.1 ± 7%) compared with glaucoma suspects (60.3 ± 5%) and healthy eyes (64.2 ± 3%) (P < 0.001).

DiagnosisCross-sectionalCross-sectional Studyn=261 eyes of 164 participantsCh5Ch12

In a cross-sectional study of 261 eyes from 164 healthy, glaucoma suspect, and open-angle glaucoma (OAG) participants, age-adjusted mean whole image vessel density (wiVD) was significantly lower in OAG eyes (46.2 ± 6%) compared with glaucoma suspects (51.3 ± 5%) and healthy eyes (56.6 ± 3%) (P < 0.001).

DiagnosisCross-sectionalCross-sectional Studyn=261 eyes of 164 participantsCh5Ch12

For differentiating between glaucoma and healthy eyes in a cross-sectional study of 261 eyes from 164 participants, the age-adjusted area under the receiver operating characteristic curve (AUROC) was highest for whole image vessel density (wiVD) (0.94), followed by retinal nerve fiber layer (RNFL) thickness (0.92) and circumpapillary vessel density (cpVD) (0.83).

DiagnosisCross-sectionalCross-sectional Studyn=261 eyes of 164 participantsCh5Ch12

For differentiating between healthy and glaucoma suspect eyes in a cross-sectional study of 261 eyes from 164 participants, the age-adjusted area under the receiver operating characteristic curve (AUROC) was highest for whole image vessel density (wiVD) (0.70), followed by circumpapillary vessel density (cpVD) (0.65) and retinal nerve fiber layer (RNFL) thickness (0.65).

DiagnosisCross-sectionalCross-sectional Studyn=261 eyes of 164 participantsCh5Ch11

Optical coherence tomography angiography (OCT-A) vessel density had similar diagnostic accuracy to retinal nerve fiber layer (RNFL) thickness measurements for differentiating between healthy and glaucoma eyes in a cross-sectional study of 261 eyes from 164 participants.

DiagnosisCross-sectionalCross-sectional Studyn=261 eyes of 164 participantsCh5Ch12

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