scholarly journals Optic Disc Vascularization in Glaucoma: Value of Spectral-Domain Optical Coherence Tomography Angiography

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Pierre-Maxime Lévêque ◽  
Pierre Zéboulon ◽  
Emmanuelle Brasnu ◽  
Christophe Baudouin ◽  
Antoine Labbé

Purpose. To detect changes in optic nerve head (ONH) vascularization in glaucoma patients using spectral-domain OCT angiography (OCT-A).Material and Method. Fifty glaucoma patients and 30 normal subjects were evaluated with OCT-A (AngioVue®, Optovue). The total ONH vessel density and temporal disc vessel density were measured. Clinical data, visual field (VF) parameters, and spectral-domain OCT evaluation (RNFL: retinal nerve fiber layer thickness, GCC: ganglion cell complex thickness, and rim area) were recorded for glaucoma patients. Correlations among total and temporal ONH vessel density and structural and VF parameters were analyzed.Results. In the glaucoma group, total and temporal ONH vessel density were reduced by 24.7% (0.412 versus 0.547;p<0.0001) and 22.88% (0.364 versus 0.472;p=0.001), respectively, as compared with the control group. Univariate analysis showed significant correlation between rim area (mm2) and temporal ONH vessel density (r=0.623;p<0.0001) and total ONH vessel density (r=0.609;p<0.0001). Significant correlations were found between temporal and total ONH vessel density and RNFL, GCC, VF mean deviation, and visual field index.Conclusion. In glaucoma patients OCT-A might detect reduced ONH blood vessel density that is associated with structural and functional glaucomatous damage. OCT-A might become a useful tool for the evaluation of ONH microcirculation changes in glaucoma.

2020 ◽  
Vol 9 (3) ◽  
pp. 697 ◽  
Author(s):  
Ga-In Lee ◽  
Kyung-Ah Park ◽  
Sei Yeul Oh ◽  
Doo-Sik Kong

Background: To evaluate the potential of vessel density alterations for predicting postoperative visual field (VF) improvement in chiasmal compression using optical coherence tomography angiography (OCT-A). Methods: The study investigated 57 eyes of 57 patients diagnosed with pituitary tumors and 42 eyes of 42 age and refractive error matched controls. All eyes with chiasmal compression for which preoperative optical coherence tomography (OCT) and OCT-A, and pre- and postoperative VF data were available. Preoperative vessel densities of superficial retinal capillary plexus (SRCP), deep retinal capillary plexus (DRCP), and radial peripapillary capillary (RPC) segment were utilized by OCT-A. Results: Preoperative peripapillary retinal nerve fiber layer and ganglion cell layer complex thickness and vessel densities of SRCP and RPC segments in eyes with chiasmal compression were significantly reduced compared with healthy controls (p < 0.001, p < 0.001, p = 0.007, and p = 0.020, respectively). In multivariate regression analysis, preoperative perimetric mean deviation (MD) (p = 0.002) and vessel density of SRCP (p = 0.025) were correlated significantly with postoperative perimetric MD. Spearman’s correlation analysis revealed significant correlations between preoperative MD on perimetry (r = 0.443, p = 0.001), vessel densities of SRCP (r = 0.288, p = 0.035) and RPC segment (r = 0.347, p = 0.009), and postoperative perimetric MD. Conclusions: Structural degeneration referred to as microvascular alterations measured by OCT-A and preoperative VF defects were associated with worse postoperative VF prognosis. Parafoveal and peripapillary vessel densities may serve as a sensitive, structural prognostic factors in the preoperative judgement of chiasmal compression.


2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Mustafa Ataş ◽  
İsa Yuvacı ◽  
Süleyman Demircan ◽  
Emel Güler ◽  
Orhan Altunel ◽  
...  

Purpose. To assess the macular, choroid, and peripapillary nerve fiber layer thickness (RNFL) in Behçet’s disease (BD) patients with and without ocular involvement by means of optical coherence tomography (OCT) and compare these findings with healthy controls.Design. Eighty patients with BD and 40 healthy controls who were followed up at the Uveitis and Retina Clinic of the Kayseri Research and Education Hospital in Turkey were enrolled in this prospective study.Subjects and Controls. The patients with BD were divided into two groups according to the presence of ocular involvement. Group 1 consisted of 40 eyes of 40 patients with ocular involvement and group 2 consisted of 40 eyes of 40 patients without ocular involvement.Methods. All of the patients and controls underwent macular, choroid, and peripapillary nerve fiber layer thickness analysis with Spectralis domain OCT (Spectralis OCT Heidelberg Engineering, Dossenheim, Germany).Main Outcome Measures. The differences in macular, choroid, and peripapillary nerve fiber layer thicknesses between groups were analyzed statistically.Results. Macular thickness was thinner in patients with BD than in the control group; this result was statistically significant (P= 0.05). There was no statistically significant difference in thickness between RNFL analysis of the patients with BD and control subjects. However, the BD patients with ocular involvement had statistically significant thinning in RNFL compared with BD patients without ocular involvement. Although the choroid was thicker in patients with BD than in the control group, it did not reach a statistically significant level (P= 0.382).Conclusions. BD with ocular involvement may be associated with decreased macular and RNFL thickness measured with spectral-domain OCT.


2020 ◽  
Author(s):  
Xiaoxiao Chen ◽  
Xiaolei Wang ◽  
Xinxin Hu ◽  
Xinghuai Sun

Abstract Background: We wish to evaluate the vessel density using optical coherence tomography angiography (OCTA) in juvenile ocular hypertension (JOHT). In addition, we investigate the potential risk parameters of intraocular pressure (IOP) and vertical cup/disc ratio (CDR) with OCTA for observing the development of JOHT. Methods: We examined 86 eyes in 45 healthy subjects and 65 eyes in 34 patients with JOHT using OCTA at the glaucoma clinic of the Eye, Nose, and Throat Hospital of Fudan University. The vessel density (VD) of radial peripapillary capillaries (RPC) and perifoveal superficial vascular plexus (SVP) was compared between healthy and JOHT group. Other basic study factors such as: age, sex, blood pressure, best-corrected visual acuity, central corneal thickness, IOP, CDR, the thickness of retinal nerve fiber layer, ganglion cell complex, visual field mean deviation, and pattern standard deviation were also recorded. Results: Temporal RPC-VD was negatively associated with IOP (p=0.043). Additional five sections of nasal, inferior-nasal, inferior-temporal, superior-temporal and superior-nasal of RPC-VD showed positive correlation with CDR. SVP-VD in superior and nasal regions were affected by high IOP (p=0.023 and p=0.049). No other difference was uncovered between healthy and JOHT subjects. Conclusions: Peripapillary temporal perfusion had negative correlation with IOP in JOHT subjects. And regions were positively correlated with large CDR. Perfusion of perifoveal regions were only affected by IOP. We conclude that OCTA could be used as an effective technique to monitor the development of JOHT.


2019 ◽  
Author(s):  
Yang Zhang ◽  
Shunhua Zhang ◽  
Chan Wu ◽  
Yao Zhang ◽  
Ailing Bian ◽  
...  

Abstract Background: To detect the macular vessel density (MVD) changes in primary angle closure glaucoma (PACG) and to investigate the correlation between MVD and other glaucomatous changes. Methods: A case-control study. Eyes of 22 PACG patients with an episode of acute primary angle closure (APAC) in one of the two eyes. Structural OCT scans were used to obtain peripapillary retinal nerve fiber layer (RNFL), macular ganglion cell complex (GCC) thickness and C/D area ration. OCT angiography (OCTA) was used to measure MVD. Results: In the control group, the dense macular blood vessels were visible on OCTA, the macular vessels were sparse in the case group, and with an enlarged fovea avascular zone. There was a reduction in MVD in the case group compared with the controls (P<0.01). No correlations between MVD, VF mean deviation (MD), C/D area ratio, GCC thickness or RNFL thickness were found in the control group. In the case group, the Pearson correlation analysis showed that MVD was significantly correlated with BCVA (r=0,65, P=0.001), GCC (r=0.50, P=0.018) and VF MD (r=-0.54, P=0.009). In the case group, the multiple stepwise regression analysis, in which MVD were considered the dependent variables, showed that BCVA and GCC were significant predictors. Conclusions: Macular microvascular network attenuated and MVD reduced significantly caused by APAC. MVD was strongly linked to BCVA and GCC.


2021 ◽  
Vol 10 (10) ◽  
pp. 2190
Author(s):  
Duri Seo ◽  
Taekjune Lee ◽  
Joo Yeon Kim ◽  
Gong Je Seong ◽  
Wungrak Choi ◽  
...  

In this retrospective study, clinical characteristics and glaucoma progression of open-angle glaucoma (OAG) patients who discontinued intraocular pressure (IOP)-lowering medication during pregnancy were investigated. Glaucoma progression was determined using either serial visual field tests or optic disc/retinal nerve fiber layer (RNFL) photographs. Age, number of previous pregnancies, diagnosis, average IOP, IOP fluctuation, visual field mean deviation, pattern standard deviation, and RNFL thickness were examined, and their association with glaucoma progression was determined using linear regression analysis. Among 67 eyes (37 patients), 19 eyes (28.4%) exhibited glaucoma progression 13.95 ± 2.42 months after delivery. The progression group showed significantly higher mean IOP than the nonprogression group in the first, second, and third trimesters (p = 0.02, 0.001, and 0.04, respectively). The average IOP in the second, and third trimesters and IOP fluctuation during the entire pregnancy were significantly associated with glaucoma progression according to a univariate analysis (p = 0.04, 0.031, and 0.026, respectively). In conclusion, IOP elevation during pregnancy is associated with glaucoma progression after delivery in patients who had discontinued medication during pregnancy. Therefore, close monitoring of glaucoma is necessary, particularly if patients discontinue medication during pregnancy, and appropriate intervention should be considered in case of increased IOP.


2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Yi Zha ◽  
Juanjuan Chen ◽  
Shuyu Liu ◽  
Jinfei Zhuang ◽  
Jianqiu Cai

Purpose. To measure the macular retinal vessel density (VD) and peripapillary retinal nerve fiber layer (RNFL) in primary angle-closure suspects (PACS) by Angio-OCT to be compared with normal subjects. Methods. Primary angle-closure suspect patients and normal subjects were enrolled in this study. The demographic and clinical characteristics of all subjects, such as RNFL thickness, retinal vessel density, and ocular perfusion pressure, were compared. Results. No significant difference was found in both groups on age, sex distribution, intraocular pressure (IOP), and retinal vessel density. The PACS group exhibited significantly thicker RNFL thickness compared with the control group. The deep vessel density was negatively associated with age ( P = − 0.034 ), while IOP had negative association with ACD ( P = − 0.019 ). OPP was independently associated with RNFL ( B = 0.334 , P = 0.038 ) in the PACS group. Conclusions. OCTA showed significant thicker change on RNFL in the PACS group. Only OPP was independently associated with RNFL in the PACS group.


2005 ◽  
Vol 15 (5) ◽  
pp. 550-555 ◽  
Author(s):  
P. Brusini ◽  
C. Tosoni ◽  
L. Parisi ◽  
L. Rizzi

Purpose To study the importance of the central corneal thickness (CCT) in patients with ocular hypertension in a 2-year follow-up. Methods A total of 110 subjects with ocular hypertension (intraocular pressure [IOP] >21 mmHg and normal automated visual field test) were admitted to the study. All patients periodically underwent the following tests: 1) circadian IOP curve; 2) standard automated perimetry (SAP, Humphrey 30–2 SITA test); 3) short wavelength automated perimetry (SWAP); 4) frequency doubling technology perimetry (FDT, N-30 threshold test); 5) nerve fiber layer analysis with GDx; 6) ibopamine test; 7) ultrasonic pachymetry. Patients were divided into three groups, based on corneal thickness. The frequency of abnormal tests within these groups was evaluated with the Pearson's χ2 test. Baseline IOP was corrected using the Doughty and Zaman formula. CCT was also considered as a continuous variable. A control group of 48 normal subjects was also considered. Results The mean CCT was 562.8 um ± 37.7. The difference with respect to normal subjects was statistically significant (p<0.01). Using the correction formula, 43 eyes (39.1%) had an IOP <21 mmHg. Abnormal test results were more frequently found with FDT. The percentage of abnormal results was found to be inversely proportional to CCT. The other tests gave inconsistent or conflicting results. Using the values of CCT as a continuous variable, no significant association was found with the GDx number and the visual field indices. Conclusions The results of our 2-year study confirm the importance of CCT measurement in the evaluation of the risk of developing glaucomatous damage.


2021 ◽  
Vol 8 ◽  
Author(s):  
Yali Wu ◽  
Qing Cun ◽  
Yijin Tao ◽  
Wenyan Yang ◽  
Jia Wei ◽  
...  

Purpose: To investigate the clinical significance of macular estimated retinal ganglion cell (mRGC) and estimated retinal ganglion cell (eRGC) in the diagnosis and staging of glaucoma.Methods: This is a cross-section study. All enrolled subjects underwent standard automated perimetry (SAP) and optical coherence tomography (OCT) examination. Swedish Interactive Threshold Algorithm (SITA)-FAST detection strategy and 24-2, 10-2 detection programs were employed in SAP assessment. The visual-field parameters and OCT parameters were calculated according to three formulas to obtain the eRGC and mRGC1 or mRGC2. The efficiency of eRGC, mRGC1, and mRGC2 estimates for the staging of glaucoma was compared. The sensitivity and specificity of each parameter for diagnosis of glaucoma were analyzed using the receiver operating characteristic (ROC) curve.Results: A total of 119 eyes were included in the analysis. Compared with the healthy controls, eRGC, mRGC1, and mRGC2 estimates were significantly decreased in patients with glaucoma. As glaucoma progressed, eRGC, mRGC1, and mRGC2 estimates were gradually reduced. In preperimetric glaucoma, mRGC1, mRGC2, and eRGC were reduced by 13.2, 14.5, and 18%, respectively. In the mild stage of glaucoma, mRGC1, mRGC2, and eRGC were reduced by 28, 34, and 38%, respectively. In the advanced stage of glaucoma, mRGC1, mRGC2, and eRGC were reduced by 81, 85, and 92% respectively. The proportion of retinal ganglion cell (RGC) loss in the macula was close to that outside the macula. The specificity at 95% gave a sensitivity of 95.51, 86.52, and 87.64% for eRGC, mRGC1, and mRGC2, respectively. The sensitivity of structural parameters macular ganglion cell complex thickness and retinal nerve fiber layer (RNFL) were 98.88 and 95.51%, respectively. The sensitivity of functional parameters mean deviation (24-2) and visual field index (VFI) were 80.90 and 73.03%, respectively. The area under ROC curve of mRGC1, mRGC2, and eRGC were 0.982, 0.972, and 0.995 (P &lt; 0.0001), respectively.Conclusion: Estimated retinal ganglion cell, mRGC1, and mRGC2 provide value to the staging of glaucoma and better diagnostic performance. Macular RGC estimatesthat integration of both structural and functional damages in macular may serve as a sensitive indicator for assessing macular damage in glaucoma and are of importance for the diagnosis and progression management of glaucoma.


2021 ◽  
Vol 10 (19) ◽  
pp. 4414
Author(s):  
Paolo Brusini

Background: The classification of damage in glaucoma is usually based either on visual field or optical coherent tomography (OCT) assessment. No currently available method is able to simultaneously categorize functional and structural damage. Material and Methods: In this study, 283 patients with chronic open-angle glaucoma (OAG) at different stages and 67 healthy subjects were tested with both standard automated perimetry and spectral domain OCT for retinal nerve fiber layer (RNFL) assessment. The visual field data were classified using the Glaucoma Staging System 2, whereas OCT results were processed with the OCT Glaucoma Staging System. These data were used to create a new staging system (global glaucoma staging system, GGSS), in which the severity of visual field and RNFL damage is reported on the Y and X axis, respectively. The GGSS was tested in a different sample of 147 patients with manifest OAG, 56 with preperimetric glaucoma and 43 normal subjects. A six-stage clinical classification, based on the analysis of visual fields and optic disc appearance, was used as gold standard. Results: The GGSS was able to correctly classify in the same stage or within the immediately adjacent stages 145 cases on 147 (98.6%). Fifty-four preperimetric cases (96.4%) were classified as borderline or abnormal (Stage 1 or 2). Here, 41 normal eyes out of 43 were correctly classified as Stage 0, with a specificity of 95.3%. Conclusions: Preliminary results from this study are encouraging and suggest that the new GGSS is able to provide information concerning the severity of structural and functional damage in an integrated manner.


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