Dataset Information

Peripapillary and Macular Vessel Density in Patients with Primary Open-Angle Glaucoma and Unilateral Visual Field Loss.

ABSTRACT: PURPOSE:To characterize OCT angiography (OCT-A) vessel density of patients with primary open-angle glaucoma (POAG) with unilateral visual field (VF) loss. DESIGN:Cross-sectional study. PARTICIPANTS:A total of 33 patients with POAG with a VF defect in 1 eye (mean VF mean deviation [MD], -3.9±3.1 decibels [dB]) and normal VF in the other eye (mean VF MD, -0.2±0.9 dB) and 33 healthy eyes. METHODS:All subjects underwent OCT-A imaging, spectral-domain (SD)-OCT imaging, and VF testing. OCT-A retinal vascular measurements were summarized as whole image vessel density (wiVD), circumpapillary vessel density (cpVD), and parafoveal vessel density (pfVD). Inter-eye differences in vascular measures, as well as SD OCT retinal nerve fiber layer (RNFL), macular ganglion cell complex (mGCC) thickness, and rim area measurements in glaucoma and healthy eyes were compared. Areas under the receiver operating characteristic curves (AUROCs) were used to evaluate diagnostic accuracy for differentiating between unaffected eyes of patients with POAG and healthy eyes. MAIN OUTCOME MEASURES:Difference in OCT-A vessel density and SD OCT structural parameters between unaffected eyes of patients with POAG with the fellow affected eyes and healthy controls. RESULTS:Mean wiVD in unaffected eyes of patients with POAG (52.0%) was higher than in their fellow affected eyes (48.8%) but lower than in healthy eyes (55.9%; P < 0.001). Mean circumpapillary RNFL (cpRNFL) thickness, mGCC thickness, and rim area measurement in unaffected eyes of patients with POAG (87.5 ?m, 87.7 ?m, and 1.0 mm2) were also higher than those measurements in their fellow eyes (76.5 ?m, 79.5 ?m, and 0.8 mm2; P < 0.001) and lower than in healthy eyes (98.0 ?m, 94.5 ?m, and 1.4 mm2; P < 0.001). The AUROCs for differentiating unaffected eyes of patients with POAG from healthy eyes were highest for wiVD (0.84), followed by mGCC (0.78), cpRNFL (0.77), and pfVD (0.69). CONCLUSIONS:OCT-A measures detect changes in retinal microvasculature before VF damage is detectable in patients with POAG, and these changes may reflect damage to tissues relevant to the pathophysiology of glaucoma. Longitudinal studies are needed to determine whether OCT-A measures can improve the detection or prediction of the onset and progression of glaucoma.

SUBMITTER: Yarmohammadi A

PROVIDER: S-EPMC5866192 | biostudies-literature | 2018 Apr

REPOSITORIES: biostudies-literature

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Peripapillary and Macular Vessel Density in Patients with Primary Open-Angle Glaucoma and Unilateral Visual Field Loss.

Yarmohammadi Adeleh A Zangwill Linda M LM Manalastas Patricia Isabel C PIC Fuller Nathanael J NJ Diniz-Filho Alberto A Saunders Luke J LJ Suh Min Hee MH Hasenstab Kyle K Weinreb Robert N RN

Ophthalmology 20171122 4

<h4>Purpose</h4>To characterize OCT angiography (OCT-A) vessel density of patients with primary open-angle glaucoma (POAG) with unilateral visual field (VF) loss.<h4>Design</h4>Cross-sectional study.<h4>Participants</h4>A total of 33 patients with POAG with a VF defect in 1 eye (mean VF mean deviation [MD], -3.9±3.1 decibels [dB]) and normal VF in the other eye (mean VF MD, -0.2±0.9 dB) and 33 healthy eyes.<h4>Methods</h4>All subjects underwent OCT-A imaging, spectral-domain (SD)-OCT imaging, an ...[more]

PMID: 29174012

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Project description:PurposeTo compare the fractal dimensions of the peripapillary microvasculature as obtained by optical coherence tomography angiography (OCTA) between primary open-angle glaucoma (POAG) and controls.MethodsOptic nerve head and peripapillary area images were taken using the 20° × 20°-scan of Spectralis OCTA (Heidelberg Engineering) in 97 subjects (64 POAG patients, 33 control patients). The optic nerve head microvasculature was evaluated according to predefined slabs: the superficial vascular complex (SVC) and the avascular complex (AVC). The en face image of each slab was processed by ImageJ software (National Institutes of Health) in order to calculate the vessel density and the fractal dimension using the box-counting method. For comparison, the peripapillary retinal nerve fiber layer (RNFL) thickness was obtained from Spectralis OCT circle scans. The utilities of the parameters for discriminating between the POAG and control groups were assessed using areas under the receiver operating characteristic curves (AUCs).ResultsThe SVC fractal dimension was lower in the POAG than in the control group (p < 0.001), while AVC showed no intergroup difference (p = 0.563). The fractal dimension showed a good correlation with the vessel density in both SVC and AVC (both p < 0.001). In a multivariable regression analysis, the SVC fractal dimension was negatively correlated with age (p < 0.001) and axial length (p < 0.001) and positively correlated with average RNFL thickness (p < 0.001), while the AVC fractal dimension was positively correlated with the Bruch's membrane opening size (p = 0.013). In terms of diagnostic utility, the AUC was significantly larger for the average RNFL thickness (AUC, 0.889) than for the SVC fractal dimension (AUC, 0.772; p = 0.008).ConclusionsThe fractal dimension of SVC was associated with the average RNFL thickness and was reduced in POAG patients. Fractal dimension analysis could be used in evaluating peripapillary vascularity by OCTA.

Dataset Information

Peripapillary and Macular Vessel Density in Patients with Primary Open-Angle Glaucoma and Unilateral Visual Field Loss.

Publications

Peripapillary and Macular Vessel Density in Patients with Primary Open-Angle Glaucoma and Unilateral Visual Field Loss.

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