scholarly journals Exploring the association of collaterals and vessel density using optical coherence tomography angiography in retinal vein occlusions

2019 ◽  
Author(s):  
Hee Eun Lee ◽  
Yiyang Wang ◽  
Alaa E. Fayed ◽  
Amani A. Fawzi

AbstractPurposeUsing optical coherence tomography angiography (OCTA) to characterize the types of collaterals in eyes with retinal vein occlusion (RVO) and further investigate their correlations with vessel densities of the superficial (SCP) and the deep capillary plexus (DCP).MethodsThis cross-sectional study included 25 eyes of 23 patients with RVO. 3 × 3 mm2 OCTA macular scans were used to quantify the parafoveal vessel density (VD) of the SCP and DCP, and to classify the collaterals into one of four types (true superficial, true deep, superficial diving, and foveal collateral). Poisson regression model was used to identify significant associations between parafoveal VD and collaterals. We further compared parafoveal VD between subgroups classified by the presence of specific collateral types based on the results of a clustering algorithm.Results16 of 25 eyes (64%) developed collaterals. Of the 43 collateral vessels analyzed, 12/19 (63%) true superficial collaterals developed in eyes with central RVO, while all 10 superficial diving collaterals (100%) developed in eyes with branch RVO. Located exclusively in the SCP, true superficial collaterals were all arteriovenous (A-V), while diving collaterals were all veno-venular (V-V). We found a significant negative correlation between SCP VD and the total number of collaterals (R2 = 0.648, P < 0.001) for the entire study cohort. Furthermore, BRVO eyes that developed superficial diving collaterals and CRVO eyes that developed true superficial collaterals demonstrated statistically significant decrease in SCP VD (P-value = 0.014) and DCP VD (P-value = 0.030), respectively, as compared to their counterparts.ConclusionOur data shows that decreased capillary perfusion in RVO is associated with the development of collaterals, while the RVO type largely dictates the type of collateral that ultimately develops.

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Jingyuan Yang ◽  
Mingzhen Yuan ◽  
Erqian Wang ◽  
Youxin Chen

The aim of this study was to compare the repeatability of optical coherence tomography angiography (OCT-A) measurements of macular vessel density using four OCT-A systems, including Heidelberg Spectralis HRA, Optovue RTVue XR, Zeiss Cirrus HD-OCT 5000, and Topcon DRI OCT Triton. A cross-sectional design was used for this study. The vascular density and vascular length density of the superficial and deep retinal capillary plexuses were imaged with OCT-A using 3 mm and 6 mm scan patterns and were calculated using ImageJ. Comparisons of intraclass correlation coefficients (ICC) were conducted. We found that the OCT-A systems had various levels of repeatability. Zeiss had better repeatability for vessel density than the other systems (overall ICC = 0.936). Optovue had better repeatability for vessel length density when the 6 mm scan pattern was used (ICC = 0.680 and 0.700 for retinal superficial and deep capillary plexus, respectively). We concluded that repeatability varied when different scan patterns of various OCT-A systems were used for imaging the superficial retinal and deep capillary plexuses. Results should be seen as valid only for a given method. The repeatability of various OCT-A systems should be considered in clinical practice and in clinical trials that use OCT-A metrics as outcome measures.


2017 ◽  
Vol 102 (3) ◽  
pp. 352-357 ◽  
Author(s):  
Jayasree P Venugopal ◽  
Harsha L Rao ◽  
Robert N Weinreb ◽  
Zia S Pradhan ◽  
Srilakshmi Dasari ◽  
...  

AimsTo compare the intrasession repeatability of peripapillary and macular vessel density measurements of optical coherence tomography angiography (OCTA) in normal and glaucoma eyes, and to evaluate the effect of signal strength of OCTA scans on the repeatability.MethodsIn a cross-sectional study, three optic nerve head scans each of 65 eyes (30 normal, 35 glaucoma eyes) and three macular scans each of 69 eyes (35 normal, 34 glaucoma eyes) acquired in the same session with OCTA were analysed. Repeatability was assessed using within-subject coefficient of repeatability (CRw) and variation (CVw). Effect of signal strength index (SSI) on repeatability was evaluated with repeated-measures mixed-effects models.ResultsCRw (%) and CVw (%) of peripapillary measurements in normal eyes ranged between 3.3 and 7.0, and 2.5 and 4.4 respectively, and that in glaucoma eyes between 3.5 and 7.1, and 2.6 and 6.6. For the macular, these measurements ranged between 4.1 and 6.0, and 3.3 and 4.7 in normal eyes and 4.3 and 6.9, and 3.7 and 5.6 in glaucoma eyes. Repeatability estimates of most measurements were similar in normal and glaucoma eyes. Vessel densities of both peripapillary and macular regions significantly increased with increase in SSI of repeat scans (coefficients ranging from 0.15 to 0.38, p<0.01 for all associations).ConclusionsRepeatability estimates of OCTA measured peripapillary and macular vessel densities were similar in normal eyes and eyes with glaucoma. SSI values of the scans had a significant effect on the repeatability of OCTA with the vessel density values increasing in scans with higher SSI values.


2021 ◽  
Vol 8 ◽  
Author(s):  
Xin Wen ◽  
Zijing Li ◽  
Jianhui Xiao ◽  
Xuane Liu ◽  
Yichi Zhang ◽  
...  

Purpose: To determine the association of myopia with peripapillary and macular microvasculature in eyes with type 2 diabetes using optical coherence tomography angiography (OCTA).Methods: Diabetic patients with and without diabetic retinopathy (DR) were recruited and grouped according to myopic status in this cross-sectional study. Axial length, refractive error, and OCTA parameters were measured. OCTA parameters were analyzed with adjustment of confounding factors and further Bonferroni analysis was performed to determine the differences in multiple group comparisons.Results: Compared with the diabetic eyes without myopia, those with myopia had lower rate of DR (21.82 vs. 35.90%, χ2 = 6.190, P = 0.013), longer axial lengths (24.94 ± 0.75 vs. 23.16 ± 0.64, F = 311.055, P &lt; 0.001) and reduced whole vessel density (VD) of optic nerve head (ONH) (45.89 ± 5.76 vs. 49.14 ± 4.33, F = 19.052, P &lt; 0.001), peripapillary VD (48.75 ± 6.56 vs. 50.76 ± 4.51, F = 7.600, P = 0.006), and reduced thickness of the retinal nerve fiber layer (RNFL) (95.50 ± 12.35 vs. 100.67 ± 13.68, F = 5.020, P = 0.026). In eyes without myopia, the superficial vessel density (SVD) (46.58 ± 4.90 vs. 43.01 ± 4.25; 95% CI, 1.80–4.61; P &lt; 0.001), deep vessel density (DVD) (45.64 ± 6.34 vs. 42.15 ± 6.31; 95% CI, 1.07–5.00; P &lt; 0.001), and FD300 area density (50.31 ± 5.74 vs. 44.95 ± 6.96; 95% CI, 2.88–7.27; P &lt; 0.001) were significant reduced in eyes with DR(DR eyes) comparing to those without DR (NoDR eyes). In eyes with myopia, only SVD were significantly reduced in DR eyes comparing to NoDR eyes (41.68 ± 3.34 vs. 45.99 ± 4.17; 95% CI, 1.10–7.22; P = 0.002). In NoDR eyes, both whole VD of ONH and Peripapillary VD demonstrated a significant decrease in eyes with myopia comparing to those without myopia (49.91 ± 4.36 vs. 45.61 ± 6.32; 95% CI, 1.95–6.27; P &lt; 0.001 and 51.36 ± 4.24 vs. 48.52 ± 6.99; 95% CI, 0.56–5.11; P = 0.006, respectively).Conclusions: In diabetic patients, myopic eyes exhibited lower prevalence of DR and thinner thickness of RNFL. The refractive status could possibly impact the retinal microvascular changes from NoDR to DR stage.


2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Qin Zhu ◽  
Chunwen Chen ◽  
Jingyan Yao

Purpose. To evaluate and quantify blood perfusion and retinal thickness (RT) from the perspective of quadrants by optical coherence tomography angiography (OCTA) in adolescents with myopia and explore the relationship between axial elongation and related indexes of OCTA. Methods. A total of 88 subjects (149 eyes) with different degrees of myopia were included in this cross-sectional study. Vessel density (VD) and RT of quadrants in macular and peripheral regions were measured through OCTA. Results. The superficial VD (SVD) of the parainferior region was significantly correlated with axial length (AL) between the emmetropia (EM) group and high myopia (HI) group ( P = 0.012 ). There were significant differences in deep VD (DVD) in all quadrants, except for the foveal, perifoveal, and peri-inferior regions ( P > 0.05 ). However, there were significant alterations in the whole, parainferior, and perinasal regions ( P = 0.030 , 0.023, and 0.035) in the low-to-moderate myopia (L–M) group compared with those in the HI group. There were significant differences in the RT in all quadrants, except for the foveal, paratemporal, and paranasal regions ( P > 0.05 ) between the EM and L–M groups and the foveal region ( P > 0.05 ) between the EM and HI groups. Nevertheless, only RT in the peri-inferior region of the L–M and HI groups showed significant differences. AL was negatively correlated with SVD in the perifoveal and parainferior regions (r = −0.179, P = 0.029 ; r = −0.227, P = 0.005 ) and inversely correlated with DVD and RT in almost all quadrants, except for the foveal region (r = −0.020, P = 0.811 ; r = 0.135, P = 1.000 ). Conclusion. DVD and RT were closely associated with the severity of myopia and might be new indexes in assessing and detecting myopia development via OCTA.


2018 ◽  
Vol 103 (3) ◽  
pp. 410-414 ◽  
Author(s):  
Giuseppe Casalino ◽  
Alessandro Arrigo ◽  
Francesco Romano ◽  
Marion R Munk ◽  
Francesco Bandello ◽  
...  

AimTo describe the optical coherence tomography angiography (OCT-A) features of patients affected by acute macular neuroretinopathy (AMN).Methods This is a prospective, observational, cross-sectional study. Multimodal imaging, including spectral domain OCT (Spectralis HRA+OCT; Heidelberg Engineering, Heidelberg, Germany) and 6×6 mm swept source OCT-A (ZEISS PLEX Elite 9000; ZEISS, Dublin, California), was performed on all patients. The primary outcome measure was assessment of the vascular alterations of the superficial (SCP) and deep (DCP) capillary plexuses and choriocapillaris (CC). A segmentation of the AMN lesions using enface OCT images of photoreceptors-retinal pigment epithelium complex was used to discriminate intralesional and extralesional regions on the OCT-A enface slabs of the DCP and CC reconstructions. Each OCT-A slab was imported into ImageJ V.1.50 and digitally binarised for quantitative analyses.ResultsOverall, seven patients (mean age 19.4±3.2 years, six women) affected by AMN were included. The mean best-corrected visual acuity was 0.00±0.00 logarithm of the minimum angle of resolution. Twelve healthy age-matched subjects (mean age 22±3.4 years, 10 women) represented the control group. The quantitative analysis of global vessel densities showed that the CC vessel density was significantly lower in patients with AMN (0.495±0.03) compared with the age-matched controls (0.545±0.02) (corrected p=0.0003). The intralesional vessel density of the DCP was 0.349±0.04 in AMN and vs 0.497±0.02 in the controls (corrected p=0.0002).ConclusionsOur study confirmed inner choroidal vascular flow void as a possible pathogenetic mechanism of AMN. We also found a focal impairment of the DCP within the AMN lesions. Future studies are needed to clarify which is the primary location of the vascular insult in this condition.


2018 ◽  
Vol 103 (7) ◽  
pp. 949-954 ◽  
Author(s):  
Jayasree P Venugopal ◽  
Harsha Laxmana Rao ◽  
Robert N Weinreb ◽  
Srilakshmi Dasari ◽  
Mohammed Riyazuddin ◽  
...  

AimsTo compare the peripapillary vessel density (VD) measurements of high-density (HD) and non-HD optical coherence tomography angiography (OCTA) scans in normal and glaucoma eyes, and to evaluate the intrasession repeatability of VD measurements of HD scans.MethodsIn a cross-sectional study, 46 normal (33 subjects) and 89 glaucoma (64 patients) eyes underwent 3 HD and 1 non-HD optic nerve head OCTA scans in the same session. Agreement in VD measurements between HD and non-HD scans was assessed using Bland and Altman analysis. Repeatability of the VD measurements of HD scans was assessed using within-subject coefficient of repeatability (CRw) and variation (CVw).ResultsThe mean difference in the VDs ranged between 0.7% (temporal sector VD) and 2.0% (inferonasal sector VD), with HD scans showing significantly greater VD values than non-HD scans. The 95% limits of agreement (LoA) in glaucoma eyes ranged between −2.0% and 5.0% for whole enface VD and between −4.8% and 9.6% for superotemporal VD. CRw (%) and CVw (%) of VD measurements of HD scans ranged from 3.0 to 4.9 and from 2.0 to 3.1 in normal eyes. The same ranged from 3.2 to 6.7 and from 2.6 to 4.8, respectively, in glaucoma eyes.ConclusionsVD of HD scans was higher than that of non-HD scans. The wide 95% LoA indicates that the VD measurements of HD and non-HD scans cannot be used interchangeably. Test–retest repeatability of VDs on HD scans was as high as 6%. These results should be considered while using OCTA for longitudinal evaluation of glaucoma.


2020 ◽  
pp. 247412642095396
Author(s):  
Cason B. Robbins ◽  
Dilraj S. Grewal ◽  
Atalie C. Thompson ◽  
Stephen P. Yoon ◽  
Brenda L. Plassman ◽  
...  

Purpose: This work assesses the intrasession repeatability of capillary perfusion density (CPD) and capillary flux index (CFI) measurements on peripapillary optical coherence tomography angiography (OCTA) in healthy eyes of older adults. Methods: In this cross-sectional study, healthy volunteers aged 50 years or older underwent 4.5 × 4.5 mm OCTA imaging centered on the optic nerve head using Zeiss Cirrus HD-5000 AngioPlex (Carl Zeiss Meditec). Two consecutive images were acquired in the same eye during a single study session. CPD and CFI were assessed using AngioPlex Software (version 11.0.0.29946) for the radial peripapillary capillary plexus (average over whole scan area) and 4 quadrants (superior, inferior, temporal, and nasal). CPD and CFI repeatability was assessed by intraclass correlation (ICC), mean interocular differences using 2-tailed t test, and association with age using generalized estimating equations. Results: A total of 150 images were acquired from 75 eyes of 47 patients. For CPD, ICC results ranged from 0.7160 (nasal CPD) to 0.9218 (average CPD). For CFI, ICC results ranged from 0.6167 (temporal CFI) to 0.8976 (inferior CFI). Temporal CFI was significantly different between right and left eyes of the same patient ( P = .03). CPD and CFI decreased with age in all analyses (average CPD β coefficient –0.00172, P < .001; average CFI β coefficient −0.00278, P < .001). Conclusions: Moderate to good repeatability was observed for most peripapillary OCTA metrics; temporal measurements were least repeatable for CPD and CFI. Peripapillary CPD and CFI decrease with age even beyond the fifth decade in healthy older adults.


2020 ◽  
pp. bjophthalmol-2020-316455
Author(s):  
Carmen Mendez-Hernandez ◽  
Surina Wang ◽  
Paula Arribas-Pardo ◽  
Liseth Salazar-Quiñones ◽  
Noemi Güemes-Villahoz ◽  
...  

Background/AimsThe aim of this study was to assess the optic nerve head (ONH) and macular vessel density with optical coherence tomography angiography (OCT-A) and the ONH haemoglobin (ONH Hb) amount with Laguna ONhE program in open-angle glaucoma (OAG) patients.MethodsIn this prospective observational cross-sectional study, 67 OAG patients and 41 healthy age-sex frequency matched subjects were examined with OCT-A and retinal photos. The circumpapillary (wcpVD), optic nerve head (iVD) and macular (wmVD) capillary vessel density of OCT-A and ONH colorimetric assessment to determine the ONH Hb amount using the Laguna ONhE program were evaluated.ResultsSignificant differences between normal subjects and glaucoma patients in the wcpVD (22.18±3.42 vs 16.03±2.89%; p<0.001), iVD (18.31±5.56 vs 12.52±4.67%; p<0.001), wmVD (15.60±2.34 vs 13.34±2.32%; p<0.001) and amount of ONH Hb (71.10±1.67 vs 68.86±2.46%; p<0.001) and in the papillary cup (68.14±5.25 vs 64.77±5.08%; p=0.001) were found. The Laguna ONhE glaucoma discriminant function (GDF) index had a negative value in the OAG patients and normal values in healthy subjects (−18.76±13.31 vs 7.98±14.09; p<0.001). The area under the receiver operating characteristic (ROC) curve (AUROC) for discriminating between healthy and glaucomatous eyes was highest for wcpVD (0.93; 95% CI 0.86 to 0.97, p<0.0001), followed by GDF (0.92; 95% CI 0.86 to 0.97, p<0.0001), iVD (0.79; 95% CI 0.70 to 0.86; p<0.0001) and ONH Hb (0.78; 95% CI 0.69 to 0.85, p<0.0001). Pair wise comparisons showed that the AUROC of wcpVD (0.93) was not significantly different than GDF (0.92) (p=0.855).ConclusionLaguna ONhE program and OCT-A have similar diagnostic validity in open-angle glaucoma patients.


2017 ◽  
Vol 102 (7) ◽  
pp. 873-877 ◽  
Author(s):  
Marcus Ang ◽  
Kavya Devarajan ◽  
Suchandrima Das ◽  
Tisha Stanzel ◽  
Anna Tan ◽  
...  

AimTo newly describe a spectral-domain (SD) optical coherence tomography angiography (OCTA) for the cornea and directly compare two OCTA system scans of the same eyes with corneal vascularisation.MethodsCross-sectional, observational, comparative case series. We performed sequential OCTA scans (10 eyes of 10 subjects with corneal vascularisation,4 scans each eye) repeated using split-spectrum amplitude decorrelation algorithm angiography system (SSADA, AngioVue; Optovue Inc, USA) and SD OCTA (Angioscan; Nidek Co. Ltd, Japan) in the same region of interest. We analysed all scan images for repeatability, image quality and vessel density measurements and compared OCTA systems.ResultsWe obtained substantial interobserver repeatability in terms of image quality score (κ=0.86) for all 80 OCTA scans (median age 49 years, 50% women). The correlation was moderately good (r=0.721) when comparing vessel density measurements between OCTA systems, but greater in the SSADA compared with SD OCTA system (mean vessel density 20.3±4.9% vs 15.1±4.2%, respectively; p<0.001).ConclusionIn this pilot clinical study, we describe successful delineation of corneal vessels with substantial image quality using a new SD OCTA system. The vessel density measurements were greater using the SSADA compared with SD OCTA system in the same area of corneal vascularisation. Further studies are required to confirm the advantages, limitations and differences between these OCTA systems for the anterior segment.


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