Regional Comparisons of Optical Coherence Tomography Angiography Vessel Density in Primary Open-Angle Glaucoma

Rao, Harsha L.; Pradhan, Zia S.; Weinreb, Robert N.; Reddy, Hemanth B.; Riyazuddin, Mohammed; Dasari, Srilakshmi; Palakurthy, Meena; Puttaiah, Narendra K.; Rao, Dhanaraj A.S.; Webers, Carroll A.B.

doi:10.1016/j.ajo.2016.08.030

Cited by 243 publications

(241 citation statements)

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“…Another study demonstrated a significant reduction in radial peripapillary capillary VD, which was correlated with sites of retinal nerve fiber layer (RNFL) thinning and VF loss in glaucoma. 33 Conversely, Rao et al 32 recently reported that the diagnostic ability of the macular VD for glaucoma using OCTA was significantly lower than peripapillary VD; however, this study did not specifically target glaucomatous eyes with CVFDs.…”

Section: Discussionmentioning

confidence: 85%

“…28,29 Additionally, a significant correlation between macular inner retinal layer thickness and CVF defect (CVFD) has been reported in several studies. 26,[28][29][30][31] Recently, Rao et al 32 reported that macular vascular density (VD), evaluated by OCTA, was reduced in a glaucoma group compared with a healthy group, but diagnostic ability (area under the receiver operating characteristic curve of 0.63) was lower than that of peripapillary VD. To the best of our knowledge, little is known about the relationship between the status of FAZ microcirculation and CVFD in glaucoma patients, but a number of studies have shown reduced peripapillary or optic nerve head (ONH) VD measured with OCTA.…”

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confidence: 99%

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Alterations of the Foveal Avascular Zone Measured by Optical Coherence Tomography Angiography in Glaucoma Patients With Central Visual Field Defects

Kwon

Choi²,

Shin

et al. 2017

Invest. Ophthalmol. Vis. Sci.

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Citation: Kwon J, Choi J, Shin JW, Lee J, Kook MS. Alterations of the foveal avascular zone measured by optical coherence tomography angiography in glaucoma patients with central visual field defects. Invest Ophthalmol Vis Sci. 2017;58:163758: -164558: . DOI: 10.1167 PURPOSE. To investigate whether the area and shape of the foveal avascular zone (FAZ) as assessed by optical coherence tomography angiography (OCTA) are altered in glaucomatous eyes with central visual field defects (CVFDs). METHODS.A total of 78 patients with open-angle glaucoma with central or peripheral visual field defects (PVFDs) confined to a single hemifield were studied retrospectively. Foveal avascular zone area and circularity were measured using OCTA images from the superficial retinal layer. Central retinal visual field (VF) sensitivity using Swedish Interactive Threshold Algorithm 24-2 VF and macular ganglion cell-inner plexiform layer (mGCIPL) thickness were measured. The FAZ area between VF-affected hemimacular segments and VF-unaffected hemimacular segments in eyes with CVFDs and matched hemimacular segments of eyes with PVFDs were compared. Factors associated with the presence and severity of CVFD at initial presentation were determined. RESULTS.Eyes with CVFDs showed a significantly larger FAZ area, lower FAZ circularity, and lower mGCIPL thickness than the PVFD group. The mean hemi-FAZ area of VF-affected hemimaculas in eyes with CVFDs was significantly larger than that of the PVFD group (0.256 6 0.07 mm 2 vs. 0.184 6 0.07 mm 2 ) and the VF-unaffected hemimaculas of the CVFD group (0.179 6 0.06 mm 2 ; P < 0.05). Age, mean deviation, mGCIPL thickness, FAZ area, and circularity were associated with CVFDs (P < 0.05).CONCLUSIONS. Microcirculatory alterations in the perifovea are spatially correlated with central VF loss. Loss of FAZ circularity was significantly associated with presence of CVFD, whereas FAZ area was significantly associated with severity of CVFD.Keywords: foveal avascular zone, central visual field defects, optical coherence tomography angiography G laucoma is a leading cause of irreversible blindness and is characterized by progressive retinal ganglion cell (RGC) death and axonal loss.1,2 Ocular blood flow (OBF) impairment and/or abnormal microcirculation along with elevated IOP may play an important role in glaucoma, particularly in normaltension glaucoma (NTG) [3][4][5][6][7] ; however, the exact pathogenesis of glaucoma is still unknown. To assess the vascular integrity of OBF, different types of imaging modalities have been introduced, including fluorescein angiography (FA), Heidelberg retina flowmeter, and color Doppler. Although FA remains the gold standard for detecting vascular pathology in the retina, it is invasive and requires exposure to an exogenous contrast agent. Moreover, the axial and lateral resolution of FA allows for limited visualization of capillaries, especially in macula in which there are overlapping capillary networks. 8 Recently, noninvasive retinal microvascular imaging has become availab...

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Section: Discussionmentioning

confidence: 85%

mentioning

confidence: 99%

Alterations of the Foveal Avascular Zone Measured by Optical Coherence Tomography Angiography in Glaucoma Patients With Central Visual Field Defects

Kwon

Choi²,

Shin

et al. 2017

Invest. Ophthalmol. Vis. Sci.

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“…Significantly lower OCTA parameters (vessel density, blood flow index, and flow index) were found in glaucoma eyes in comparison with normal eyes in the peripapillary area [6, 16-50], the optic disc [19, 23, 25, 32, 36, 51-60] and the whole image macular area [16, 21, 32, 34, 36-38, 61-64]. In all of those areas, the diagnostic abilities increased with increasing severity of glaucoma [32, 34, 52].…”

Section: Resultsmentioning

confidence: 99%

“…In all of those areas, the diagnostic abilities increased with increasing severity of glaucoma [32, 34, 52]. This illustrated that an increasing severity of glaucoma was correlated with more pronounced vascular and structural damage.…”

Section: Resultsmentioning

confidence: 99%

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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“…14 Glaucoma patients often present with the loss of macular RGCs and nerve fiber layer thickness in the presence of CVF loss, even at early stages of the disease. 12,[17][18][19][20][21] Using OCTA, Rao et al 22 have demonstrated that macular vessel density (VD) in the parafoveal region (central 1-3 mm diameter zone) was reduced in patients with glaucoma compared with healthy eyes. Moreover, glaucomatous change in VD has been detected by serial OCTA measurements in the macular region in patients with primary open-angle glaucoma (POAG), suggesting the potential role of macular VD measurement to detect and monitor microvasculature changes in glaucoma.…”

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confidence: 99%

An Optical Coherence Tomography Angiography Study of the Relationship Between Foveal Avascular Zone Size and Retinal Vessel Density

Kwon

Choi²,

Shin

et al. 2018

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. To assess the relationship between the size of the foveal avascular zone (FAZ; area and perimeter) and vessel density (VD) at various retinal regions using optical coherence tomography angiography (OCTA) in patients with open-angle glaucoma (OAG).METHODS. In this retrospective cross-sectional study, OAG eyes were grouped according to the presence/absence of central visual field (CVF) defects. A control group of normal eyes was also included. OCTA images were obtained from the optic nerve (4.5 3 4.5 mm 2 ) and macular (3 3 3 mm 2 ) area, in which VDs were measured in the circumpapilla, parafovea, and fovea regions. Partial correlation analyses between FAZ parameters representing size and VDs at different retinal regions were performed. The correlation between FAZ parameters and macular ganglion cell-inner plexiform layer thickness (mGCIPLT) and CVF mean sensitivity (MS) was also assessed. For spatial correspondence, correlations between FAZ parameters and corresponding VD, mGCIPLT, and CVF-MS measurements were assessed at each hemiretina. RESULTS.A total of 126 OAG eyes and 40 controls were reviewed. Overall, FAZ parameters showed statistically significant correlations with VDs measured at the fovea, parafovea, and circumpapilla (FAZ area: r ¼ À0.603, À0.385, À0.256; P < 0.001, < 0.001, and 0.003, respectively). These correlations were observed regardless of the presence of CVF defects (all P < 0.05). FAZ size showed significant spatial correlations with VD, mGCIPLT, and CVF-MS measurements at each hemiretina.CONCLUSIONS. OCTA-derived FAZ area and perimeter showed statistically significant correlations with VDs measured at various retinal locations with spatial correspondence in OAG.

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Regional Comparisons of Optical Coherence Tomography Angiography Vessel Density in Primary Open-Angle Glaucoma

Cited by 243 publications

References 25 publications

Alterations of the Foveal Avascular Zone Measured by Optical Coherence Tomography Angiography in Glaucoma Patients With Central Visual Field Defects

Alterations of the Foveal Avascular Zone Measured by Optical Coherence Tomography Angiography in Glaucoma Patients With Central Visual Field Defects

Optical Coherence Tomography Angiography in Glaucoma: A Review

An Optical Coherence Tomography Angiography Study of the Relationship Between Foveal Avascular Zone Size and Retinal Vessel Density

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