Reliability of Vessel Density Measurements in the Peripapillary Retina and Correlation with Retinal Nerve Fiber Layer Thickness in Healthy Subjects Using Optical Coherence Tomography Angiography

She, Xiangjun; Guo, Jiaxian; Li, Xiaoying; Zhu, Hong; Li, Tong; Zhou, Minwen; Feng, Jingyang; Sun, Xiaodong

doi:10.1159/000485957

Cited by 38 publications

(38 citation statements)

References 27 publications

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“…Strong, positive associations between RNFL thickness and peripapillary VD have been previously reported,23,24 and support the idea that, in general, the quantity of perfused RPCs is proportional to the quantity of RNFL it is supplying 25–27. Prior histology and OCTA studies have demonstrated how RPCs run parallel to the RNFL and that their densities within a given eye are highly correlated 26,28.…”

Section: Discussionsupporting

confidence: 71%

Ocular Determinants of Peripapillary Vessel Density in Healthy African Americans: The African American Eye Disease Study

Nelson

Chang

LeTran

et al. 2019

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. The African American (AA) population has unique ocular anatomic characteristics and a disproportionately high incidence of glaucoma, which is associated with lower peripapillary vessel density (VD). This study aimed to identify ocular determinants of peripapillary VD in healthy AAs. METHODS. This was a cross-sectional, population-based study of 1029 AAs, ages 40 and older. Participants underwent examination to obtain axial length (AL), IOP, central corneal thickness (CCT), mean retinal nerve fiber layer (RNFL) thickness, visual field mean deviation (MD), and 6 3 6-mm optical coherence tomography angiography scans of the optic nerve. Participants with glaucoma, vision-threatening diabetic retinopathy, or other relevant ocular disease were excluded. Prototype software was used to quantify VD. A multivariable regression model, controlling for age and signal strength, identified the ocular variables that predicted peripapillary VD. The contribution of each variable was assessed with the magnitude of standardized regression coefficients (SRC). RESULTS. Based on univariate regressions, AL, RNFL thickness, and MD had significant associations with peripapillary VD (all P < 0.001). In the final multivariate model, lower mean RNFL thickness (b ¼ 0.0022, P < 0.001, SRC ¼ 0.542) and longer AL (b ¼ À0.0055, P < 0.001, SRC ¼ À0.118) were associated with lower peripapillary VD, controlling for age and signal strength, with model R 2 of 0.69. CONCLUSIONS. Thinner RNFL and longer AL were the most influential ocular determinants of lower peripapillary perfusion in healthy AA eyes. Additional research is needed to clarify whether longer AL increases risk of glaucoma by affecting capillary perfusion.

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Section: Discussionsupporting

confidence: 71%

Ocular Determinants of Peripapillary Vessel Density in Healthy African Americans: The African American Eye Disease Study

Nelson

Chang

LeTran

et al. 2019

Invest. Ophthalmol. Vis. Sci.

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“…Given the recent development of OCTA technology for quantitative metrics, the reproducibility of measurements, such as VD needs to be determined before this technique can be confidently used in clinical research and practice. [18][19][20][21] In this study, we used an SS-OCTA device equipped with new software to quantify VD in the macula and ONH. Our data indicate good reproducibility for the central measurements (foveal and papillary, respectively, ICC ⩾ 0.747) and moderate to good reproducibility in the remaining subfields examined (parafoveal and peripapillary).…”

Section: Discussionmentioning

confidence: 99%

“…[15][16][17] However, as this technology is relatively new, data on the reproducibility of OCTA measurements are still scarce. [18][19][20][21] In the present study, we assessed the reproducibility of swept-source (SS)-OCTA macular and ONH (papillary and peripapillary) VD measurements in healthy individuals (Tables 1 and 2).…”

Section: Reproducibility Of Macular and Optic Nerve Head Vessel Densimentioning

confidence: 99%

Reproducibility of macular and optic nerve head vessel density measurements by swept-source optical coherence tomography angiography

Fernández‐Vigo

Kudsieh²,

Macarro-Merino³

et al. 2019

European Journal of Ophthalmology

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Purpose: To assess the reproducibility of swept-source optical coherence tomography angiography (SS-OCTA) for macular and optic nerve head (ONH) vessel density (VD). Methods: Cross-sectional study using the Triton OCTA (Topcon, Tokyo, Japan), for VD (%) measurements in 40 eyes of 40 healthy subjects on two 6 × 6 mm scans of the macula and ONH across five subfields (central, superior, inferior, temporal, and nasal) at different segmentation levels: superficial capillary plexus (SCP), deep capillary plexus (DCP), outer retina, and choriocapillaris. Reproducibility values were summarized as intraclass correlation coefficients (ICCs) and coefficients of variations (CV). Results: ICCs for the macular VD measurements in the central zone were 0.874, 0.770, 0.575, 0.718 at the levels SCP, DCP, outer retina, and choriocapillaris, respectively, while worse ICCs were obtained for the parafoveal subfields (ICC ⩽ 0.589); CVs were 2.8%–6.7%. The reproducibility of the ONH superficial VD was ICC = 0.941 for the papillary region and was ICC = 0.499–0.853 for the peripapillary zone; CVs ranged from 4.8% to 17%. Peripapillary VD showed an ICC = 0.533–0.770 in the DCP layer, and 0.572–0.828 in the choriocapillaris. Lowest VD were obtained for the macular SCP and DCP (23% and 22%, respectively), in the foveal zone, while greatest VD were recorded in the nasal and temporal peripapillary subfields at the level of the choriocapillaris (both 68%). Conclusions: The new SS-OCTA software served to quantify macular and ONH VD with a reproducibility that was good in the central zones (foveal and papillary, respectively) and moderate in the peripheral zones (parafoveal and peripapillary).

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“…Of the included scans, the median image quality was 8 (range, 7–9) for the parafoveal scans and 7 (7–8) for the peripapillary scans. To elucidate whether the angiographic imaging signal and its subsequent analysis are truly informative, we also recorded as a secondary outcome the parafoveal ganglion-cell complex thickness (GCC) and the peripapillary retinal nerve fiber layer thickness (RNFLT), which have been previously shown to positively correlate with PCD even in healthy subjects 14…”

Section: Methodsmentioning

confidence: 99%

Quantification and Repeatability of Vessel Density and Flux as Assessed by Optical Coherence Tomography Angiography

Pappelis

Jansonius

2019

Trans. Vis. Sci. Tech.

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Purpose To determine the intrasession repeatability (test-retest variability) of parafoveal and peripapillary perfused capillary density (PCD) and normalized flux index (NFI) as assessed with Canon OCT-HS100 angiography. Methods Pairs of optical coherence tomography angiography (OCT-A) images were obtained from the parafoveal and peripapillary region of 30 eyes of 30 healthy subjects. PCD and NFI were calculated using generic image-processing software. Macular ganglion-cell complex thickness (GCC) and peripapillary retinal nerve fiber layer thickness (RNFLT) were also recorded. Bland-Altman analysis was performed and the coefficient of repeatability (CoR) and intraclass correlation coefficient (ICC) were calculated. Correlations of parafoveal PCD/NFI with GCC and of peripapillary PCD/NFI with RNFLT were also computed. Results Mean (standard deviation) parafoveal and peripapillary PCD were 40.0% (1.8%) and 44.5% (1.3%), respectively. Corresponding values for NFI were 151.2 (6.8) and 164.2 (3.9). For PCD, ICC was 0.76 for parafoveal and 0.79 for peripapillary measurements; corresponding CoRs were 2.7% and 1.8%. Corresponding values for NFI were 0.62 and 0.67 for ICC and 13.3 and 7.0 for CoR. Average measures ICC was 0.87/0.88 and 0.76/0.80 for the parafoveal/peripapillary PCD and NFI, respectively. PCD and NFI were weakly correlated with GCC ( r = 0.39, P = 0.035; r = 0.33, P = 0.077) and moderately correlated with RNFLT ( r = 0.43, P = 0.017; r = 0.55, P = 0.002). Conclusions Repeatability of a commercially available OCT-A with generic image-processing software was good (NFI) to excellent (PCD). Our results indicate that changes surpassing the variability in healthy subjects should be easily detectable in a clinical setting. Translational Relevance Repeatability estimates provide information regarding the relevance of changes in retinal perfusion.

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Reliability of Vessel Density Measurements in the Peripapillary Retina and Correlation with Retinal Nerve Fiber Layer Thickness in Healthy Subjects Using Optical Coherence Tomography Angiography

Cited by 38 publications

References 27 publications

Ocular Determinants of Peripapillary Vessel Density in Healthy African Americans: The African American Eye Disease Study

Ocular Determinants of Peripapillary Vessel Density in Healthy African Americans: The African American Eye Disease Study

Reproducibility of macular and optic nerve head vessel density measurements by swept-source optical coherence tomography angiography

Quantification and Repeatability of Vessel Density and Flux as Assessed by Optical Coherence Tomography Angiography

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