Vessel density in OCT angiography permits differentiation between normal and glaucomatous optic nerve heads

Lommatzsch, Claudia; Rothaus, Kai; Koch, Jörg; Heinz, Carsten; Grisanti, Swaantje

doi:10.18240/ijo.2018.05.20

Cited by 22 publications

(15 citation statements)

References 33 publications

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“…24 Other results indicate the VCD in the radial papillary capillaries layer and in the nerve head layer of glaucomatous eyes was significantly lower than in age-matched control eyes. 1 The same authors presented results that VCD in all peripapillary segments was higher than in nerve head layer, similar to our findings.…”

Section: Discussionsupporting

confidence: 91%

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Analysis of structural and vascular changes of the optic nerve head and macula in different stages of primary open angle glaucoma

et al. 2022

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Aim. This study evaluates the structural and vascular changes of the optic nerve head (ONH) and macula in healthy and primary open-angle glaucoma (POAG) eyes, detected by optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA). Additionally, it examines the correlation of the OCT and OCTA measurements and their association with the presence of POAG. Methods. A total of 196 eyes were included and classified into four groups. Forty-eight healthy eyes, 51 eyes with mild POAG, 50 eyes with moderate POAG, and 47 eyes with advanced glaucoma. All subjects underwent standard ophthalmic examination. OCT measured the mean, superior and inferior retinal nerve fiber layer (RNFL) thickness and macular ganglion cell complex (GCC). OCTA evaluated the vessel capillary density (VCD) in ONH, foveal avascular zone (FAZ) and macular vessel density (VD) in the superficial (SL) and deep (DL) retinal vascular plexus. Results. Patient characteristics were similar except for decreased visual acuity, thinner corneas, higher IOP and higher the cup/disc ratio in POAG patients. OCT results showed that RNFL and GCC thickness gradually decreased according to POAG severity. Within the assessment conducted by OCTA, VCD's value in ONH also diminished with the progression of POAG, having the lowest value in patients with advanced glaucoma. A same pattern was observed in vessel density around FAZ (FD) and VD values. Comparing the structural and vascular changes, a significant positive correlation was found between RNFL thickness and VCD inside disc (ID) in ONH, and GCC and VD SL in the macular zone. Conclusion. OCT and OCTA allow for a non-invasive quantification of the structural and vascular changes in ONH and the macular zone and accurately distinguish between healthy 4 eyes and eyes with POAG, showing an association with the presence and progression of glaucoma.

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Section: Discussionsupporting

confidence: 91%

“…Glaucoma represents the second leading cause of blindness worldwide. 1 It is a progressive optic neuropathy leading to preventable but irreversible visual defects. 2 It remains unclear whether the decreased retinal blood flow is the cause or result of an optic nerve glaucomatous damage.…”

Section: Introductionmentioning

confidence: 99%

Analysis of structural and vascular changes of the optic nerve head and macula in different stages of primary open angle glaucoma

et al. 2022

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“…13 It has been reported previously that papillary and macular VD is lower in glaucomatous eyes than in age-matched normal eyes. 11,14 We were able to learn from our preliminary work that in glaucomatous eyes vessel density is significantly reduced in comparison to healthy eyes 15,29 and that on average in healthy eyes there is a papillary vessel density of more than 50%. 29 Most of the research using OCTA has compared the VD of healthy eyes and eyes with POAG, with few publications considering different glaucoma entities in detail.…”

Section: Discussionmentioning

confidence: 96%

<p>Vessel Density in Glaucoma of Different Entities as Measured with Optical Coherence Tomography Angiography</p>

Lommatzsch

Rothaus

et al. 2019

OPTH

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Purpose: To compare papillary and macular vessel density (VD), as measured by optical coherence tomography angiography (OCTA), in eyes with primary open-angle glaucoma (POAG), normal-tension glaucoma (NTG) and exfoliation glaucoma (XFG). Methods: The papillary and macular VD of 40 eyes with POAG, 19 with NTG and 21 with XFG were examined using OCTA (AngioVue™). The VD was measured at two different layers of segmentation (optic nerve head: radial peripapillary capillary [RPC] and nerve head [NH]; macula: superficial [SL] and deep [DL] retinal vascular plexus) with a 4.5×4.5mm papillary and 6×6-mm macular scan. VD was calculated by an automated density measuring tool in the AngioVue™ software.Results: There were no significant differences in the total value of the papillary, peripapillary and macular VD. A significantly higher VD could be measured for NTG compared to POAG, as well as for XFG in the inferior nasal peripapillary sector at RPC-segmentation and at the NH-level between NDG and XFG. Conclusion: OCTA can detect a difference in VD in the nasal inferior peripapillary sector in NTG compared with POAG and XFG. These findings may help to improve the understanding of further pathophysiological mechanisms.

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“…Propagation of neurodegenerative processes related to glial reaction, neuroin ammation, mitochondrial abnormalities associated with production of reactive oxygen species, and oxidative stress, etc., lead to apoptosis of nerve cells [28,29]. In addition, age is a common risk factor for neurodegenerative diseases and the RNFL is believed to naturally decrease with age at a rate of 0.44 µm per year [30]. Meta-analyses show that pRNFL thickness decreases in AD and MCI compared with HC [31,32].…”

Section: Discussionmentioning

confidence: 99%

Quantitative Assessment of Retinal Thickness and Vessel Density Using Optical Coherence Tomography Angiography in Patients with Alzheimer’s Disease and Glaucoma

Zabel

Kałuz̊ny

Zabel

et al. 2020

Preprint

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Background Retinal imaging using optical coherence tomography (OCT) and OCT angiography (OCTA) may serve as an alternative approach to monitoring and diagnosing neurodegenerative diseases such as Alzheimer's disease (AD) and primary open-angle glaucoma (POAG). In this study, we performed direct comparisons of retinal vessel density with the thickness of inner retinal layer (IRL) and outer retinal layer (ORL) in patients with AD and POAG. Methods In this cross-sectional study, we analyzed data from 48 eyes of healthy control (HC) participants, 71 eyes of POAG patients, and 49 eyes of AD patients with confirmed presence of fibrillar brain amyloid on positron emission tomography (PET) imaging with florbetapir F 18. Ophthalmic examination included OCT imaging to measure IRL and ORL thickness in the macula and OCTA in the same region for the imaging of vessel density in the superficial vascular plexus (SVP) and deep vascular plexus (DVP) of the retina. A direct comparison of vessels density and retinal layers thickness, which different dynamic ranges, was obtained by normalizing values as percentage losses. Values were adjusted for inter-eye correlation, age, gender, and scan quality, where applicable. Results Patients with AD presented significantly greater losses of vascular density in the DVP and ORL thickness compared to POAG (p < 0.001), but percentage losses of vessel density in SVP and IRL thickness were considerable in POAG compared to AD eyes (p < 0.001). Positive associations among presence of AD were observed primarily in outer retina where a 1% decrease of ORL thickness was associated with about 24–29% increase in odds of the presence of AD. According to OCTA measurements, a 1% decrease of vessel density in DVP was positively associated with a 4–9% increase in odds of the presence of AD. In POAG positive associations among presence of disease were observed only in inner retina where 1% loss of IRL thickness and a 1% loss of vessel density in the SVP were positively associated with a 13–23% increase in risk of presence of the disease. Conclusions Analysis of ORL thickness and vessel density in DVP could potentially improve diagnostic capabilities and may provide a valuable approach for predicting of AD.

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Vessel density in OCT angiography permits differentiation between normal and glaucomatous optic nerve heads

Abstract: OCTA allows non-invasive quantification of the peripapillary and papillary VD, which is significantly reduced in glaucomatous eyes and accurately distinguishes between healthy and diseased eyes. OCTA expands the spectrum of procedures for detecting and monitoring glaucoma.

Cited by 22 publications

References 33 publications

Analysis of structural and vascular changes of the optic nerve head and macula in different stages of primary open angle glaucoma

Analysis of structural and vascular changes of the optic nerve head and macula in different stages of primary open angle glaucoma

<p>Vessel Density in Glaucoma of Different Entities as Measured with Optical Coherence Tomography Angiography</p>

Quantitative Assessment of Retinal Thickness and Vessel Density Using Optical Coherence Tomography Angiography in Patients with Alzheimer’s Disease and Glaucoma

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