Optical Coherence Tomography Angiography of the Superficial Microvasculature in the Macular and Peripapillary Areas in Glaucomatous and Healthy Eyes

Chen, Henry Shen-Lih; Liu, Chun-Hsiu; Wu, Wei‐Chi; Tseng, Hsiao‐Jung; Lee, Yung-Sung

doi:10.1167/iovs.17-21846

Cited by 170 publications

(160 citation statements)

References 35 publications

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

Section: Resultsmentioning

confidence: 99%

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

Section: Resultsmentioning

confidence: 99%

“…In the peripapillary area, the greatest differences in OCTA parameters between the normal and glaucoma groups were found in the infero- and superotemporal sectors [6, 18, 25, 35, 37, 42]. This was expected since these 2 sectors are the ones that are the most vulnerable to glaucomatous damage at an early stage [65, 66].…”

Section: Resultsmentioning

confidence: 99%

“…Several studies found a high AUC for the whole image macular vessel density, (between 0.94 and 0.98), comparable to that of the macular GCC (i.e., 0.95) [21, 37, 61]. However, other studies found only a moderate AUC for the whole image macular vessel density (between 0.69 and 0.80) [32, 34, 36], with a significantly better AUC of the macular GCC (i.e., 0.93) [34].…”

Section: Resultsmentioning

confidence: 99%

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Optical Coherence Tomography Angiography in Glaucoma: A Review

et al. 2018

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Background: Glaucoma is the leading cause of irreversible blindness worldwide. Several techniques exist for the diagnosis and follow-up of patients. Optical coherence tomography (OCT) angiography (OCTA) is a recently developed technique that provides a quantitative assessment of the microcirculation of the retina and choroid in a fast, noninvasive way. Despite it being a novel technique, several publications have already been done in the glaucoma field. However, a summary of findings is currently lacking. Aims: To perform a literature review to assess the role of OCTA in glaucoma diagnosis and follow-up. Methods: A database search was carried out using MEDLINE, Embase, and Web of Science, including all original works registered until July 23, 2017. Results: OCTA (1) has a high repeatability and reproducibility, (2) has good discriminatory power to differentiate normal eyes from glaucoma eyes, (3) is more strongly correlated with visual function than conventional OCT, (4) has good discriminatory power to differentiate early-glaucoma eyes from normal eyes (i.e., at least equal to that of OCT), (5) reaches a floor effect at a more advanced disease stage than OCT, and (6) is able to detect progression in glaucoma eyes. Conclusion: OCTA shows potential to become a part of everyday glaucoma management.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Optical Coherence Tomography Angiography in Glaucoma: A Review

et al. 2018

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“…Auch wenn der diagnostische Stellenwert dieser neuen Untersuchungstechnik nicht abschließend eingeordnet werden kann und eine isolierte Bewertung der OCTA nicht die diagnostische Aussagekraft der eingeführten morphometrischen Methoden wie der Vermessung mittels Heidelberg Retina Tomograph (HRT) und OCT erreicht, so zeigen die neuesten Studienergebnisse im Vergleich zur zirkumpapillären Nervenfaserschicht und Gesichtsfeldparametern vergleichbare diagnostische Wertigkeiten mit AUC-Werten von 0,94 [3]. Allerdings ist der klinische Wert der OCTA besonders im Frühstadium des Glaukoms unverändert unsicher [4].…”

Section: Transfer In Die Praxis Von Prof Dr Klaus Rohrschneider (Heunclassified

Wie kann die optische Kohärenztomographie-Angiographie der Glaukomdiagnostik nutzen?

Rohrschneider¹

2019

Kompass Ophthalmol

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Hintergrund: Die optische Kohärenztomographie-Angiographie (OCTA) ist eine neue, nichtinvasive Methode, die eine quantitative Beurteilung der retinalen Durchblutung und der Durchblutung am Sehnerv erlaubt. In dieser Arbeit erläutern wir die Grundlagen der Anwendung dieser Methode und geben einen Überblick über die Erkenntnisse, die durch diese Methode bei Glaukom gewonnen wurden. Methoden: Eine selektive Literaturrecherche und Auswertung eigener Daten liegen dieser Arbeit zugrunde. Ergebnisse: Quantitative OCTA-Parameter zeigen eine gute Reproduzierbarkeit bei Glaukompatienten. Glaukompatienten zeigen eine verminderte Flussdichte am Sehnerv sowie im Bereich der Makula im Vergleich zu einer gesunden Kontrollgruppe. Die Flussdichteparameter zeigen insgesamt eine gute diagnostische Diskriminierung. Sie sind aber den strukturellen Parametern, die in der Routinediagnostik angewendet werden, nicht überlegen. Die verminderte Flussdichte korreliert mit dem Ausmaß des strukturellen und funktionellen Glaukomschadens. Schlussfolgerung: Die OCTA ist nichtinvasiv, schnell und reproduzierbar. Erste Ergebnisse von Studien bei Glaukompatienten zeigen das hohe diagnostische Potenzial dieser Methode. In der klinischen Routine könnte die OCTA in Zukunft eine Rolle spielen.

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Optical Coherence Tomography Angiography Compared With Optical Coherence Tomography Macular Measurements for Detection of Glaucoma

2018

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IMPORTANCE Whether optical coherence tomography angiography (OCT-A) outperforms OCT to detect glaucoma remains inconclusive. OBJECTIVE To compare (1) the diagnostic performance for detection of glaucoma and (2) the structure-function association between inner macular vessel density and inner macular thickness. DESIGN, SETTING, AND PARTICIPANTSThis cross-sectional study included 115 patients with glaucoma and 35 healthy individuals for measurements of retinal thickness and retinal vessel density, segmented between the anterior boundary of internal limiting membrane and the posterior boundary of the inner plexiform layer, over the 3 × 3-mm 2 macula using swept-source OCT. All participants were Chinese. Visual sensitivity corresponding to the 3 × 3-mm 2 macular region was expressed in unlogged 1/lambert for investigation of the structure-function associations. Diagnostic performance was evaluated with area under the receiver operating characteristic curves (AUCs). The study was conducted between January 12, 2016, and December 12, 2016. MAIN OUTCOMES AND MEASURESArea under the receiver operating characteristic curve and R 2 analysis. RESULTSOf the 115 patients with glaucoma, 42 (36.5%) were women (mean [SD] age, 53.5 [13.4] years); of the 35 individuals with healthy eyes, 25 (71.4%) were women (age, 60.6 [5.9] years). Inner macular vessel density and thickness were 4.3% (95% CI, 2.4%-6.1%) and 21.1 μm (95% CI, 17.4-24.9 μm) smaller, respectively, in eyes with glaucoma compared with healthy eyes. The AUC of mean inner macular thickness for glaucoma detection was greater than that of mean inner macular vessel density (difference, 0.17; 95% CI, 0.01-0.31; P = .03). At 90% specificity, the sensitivity of mean inner macular thicknesses for detection of glaucoma was greater than that of mean inner macular vessel densities (difference, 29.2%; 95% CI, 11.5%-64.6%; P = .02). The strength of the structure-function association was stronger for mean inner macular thickness than mean inner macular vessel density in the linear (difference in R 2 = 0.38; 95% CI, 0.22-0.54; P < .001) and nonlinear (difference in R 2 = 0.36; 95% CI, 0.21-0.51; P < .001) regression models.CONCLUSIONS AND RELEVANCE In this study, OCT measurement of inner macular thickness shows a higher diagnostic performance to detect glaucoma and a stronger structure-function association than the currently used OCT-A measurement of inner macular vessel density. These findings may suggest that OCT-A of the macula has a limited role in the diagnostic evaluation of glaucoma.

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Optical Coherence Tomography Angiography of the Superficial Microvasculature in the Macular and Peripapillary Areas in Glaucomatous and Healthy Eyes

Cited by 170 publications

References 35 publications

Optical Coherence Tomography Angiography in Glaucoma: A Review

Optical Coherence Tomography Angiography in Glaucoma: A Review

Wie kann die optische Kohärenztomographie-Angiographie der Glaukomdiagnostik nutzen?

Optical Coherence Tomography Angiography Compared With Optical Coherence Tomography Macular Measurements for Detection of Glaucoma

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