Optical Coherence Tomography Angiography Assessed Retinal and Choroidal Microvasculature Features in Patients with Retinitis Pigmentosa: A Meta-Analysis

Background. The aim of this study was to assess the retinal and choroidal microvasculature features using optical coherence tomography angiography (OCTA) in patients with retinitis pigmentosa (RP). Methods. This study was a meta-analysis of relevant published studies that were included after a comprehensive search of PubMed, Embase, Cochrane Library, and Web of Science databases. Mean difference (MD) with a 95% confidence interval was used to assess continuous variable outcomes. Heterogeneity was evaluated using the chi-squared test based on the values of P and I2. Results. Seven studies were included in this meta-analysis. The vessel density values measured in the superficial and deep foveal zones of RP patients using OCTA were significantly lower than the recorded values in the control groups (MD = −3.58, P=0.04; MD = −4.93, P=0.02, respectively). The superficial and deep parafoveal vessel density values measured with OCTA were also significantly lower in RP patients than in control groups (MD = −9.09, P<0.00001; MD = −10.74, P<0.00001, respectively); for choriocapillaris vessel density, there was no statistically significant difference between RP patients and controls (MD = −1.33, P=0.09). The deep foveal avascular zone (FAZ) was significantly larger in RP patients than in controls (MD = 0.15, P=0.01), whereas there was no significant difference in the superficial foveal avascular zones in the two groups (MD = 0.08, P=0.11). Conclusions. We showed that retinal and choroidal vessels were attenuated in RP patients. Additionally, we revealed that the FAZ was larger in RP patients, especially the deep FAZ. OCTA may become a useful modality in the diagnosis and monitoring of patients with RP.

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Optical Coherence Tomography Angiography Assessment of the Peripapillary Vessel Density and Structure in Patients with Nonarteritic Anterior Ischemic Optic Neuropathy: A Meta-Analysis

BioMed Research International ◽

10.1155/2020/1359120 ◽

2020 ◽

Vol 2020 ◽

pp. 1-11

Author(s):

Ling Ling ◽

Kaibao Ji ◽

Liping Xie ◽

Feifei Gao ◽

Qinglin Zhang ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Optic Neuropathy ◽

Optical Coherence Tomography Angiography ◽

Meta Analysis ◽

Vessel Density ◽

Anterior Ischemic Optic Neuropathy ◽

Cochrane Library ◽

Ischemic Optic Neuropathy ◽

Optical Coherence ◽

Rnfl Thickness

Background. This meta-analysis is aimed at assessing the peripapillary vessel density (VD) and structural outcomes using optical coherence tomography angiography (OCTA) in patients with nonarteritic anterior ischemic optic neuropathy (NAION). Methods. A comprehensive search of PubMed, Embase, Cochrane Library, and Web of Science databases for literature comparing VD and structural outcomes in patients with NAION and controls was performed. Mean differences (MDs) and its 95% confidence interval (CI) were calculated for continuous estimates. Review Manager (V5.30) was used for analysis. Results. Fourteen published studies met the requirement. The radial peripapillary capillary (RPC) whole enface VD measured by OCTA was significantly lower in patients with NAION compared to that of the controls ( MD = − 10.51 , P < 0.00001 ). The RPC inside disc VD was significantly decreased in the NAION group than that in the control group ( MD = − 8.47 , P < 0.00001 ). For RPC peripapillary VD, there was a statistically significant difference between patients with NAION and the controls ( MD = − 12.48 , P < 0.00001 ). The peripapillary retinal nerve fibre layer (p-RNFL) thickness was significantly lower in patients with NAION in comparison to the controls ( MD = − 22.18 , P = 0.004 ). The ganglion cell complex (GCC) thickness in the macular zone of NAION patients was remarkably reduced compared to that in the controls ( MD = − 17.18 , P = 0.0002 ). Conclusions. The findings suggested that the peripapillary VD and RNFL thickness were attenuated, and the macular GCC thickness was reduced in patients with NAION. OCTA, in the future, may facilitate the diagnosis and monitoring of patients with NAION.

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Outer Macular Microvascular Supply in Retinitis Pigmentosa Examined using Optical Coherence Tomography Angiography

Journal of Ophthalmology ◽

10.1155/2021/5575851 ◽

2021 ◽

Vol 2021 ◽

pp. 1-5

Author(s):

Mingsheng Hong ◽

Jiquan Wen ◽

Jixian Lou ◽

Jiehui Xu ◽

Tingjun Xu

Keyword(s):

Optical Coherence Tomography ◽

Retinitis Pigmentosa ◽

Optical Coherence Tomography Angiography ◽

Vessel Density ◽

Spectral Domain ◽

Optical Coherence ◽

Cross Sectional ◽

Important Indicator ◽

Defect Groups ◽

Significant Difference

Purpose. To determine the vessel density of the superior (SCP) and deep retinal capillary plexuses (DCP) in patients with retinitis pigmentosa (RP) using optical coherence tomography angiography (OCTA). Methods. This was a cross-sectional study. A total of 25 eyes of 25 healthy volunteers and 30 eyes of 17 patients with RP were evaluated in this study. The integrity of the ellipsoid zone in the macular fovea was evaluated as an intact or defect using a spectral-domain OCT. Commercial spectral domain coherence tomography angiography (OCTA) was used to scan the macular region of approximately 3 × 3 mm2. The vessel density in the SCP and DCP were calculated after appropriate layer segmentation and removal of projection artifacts. The central retinal thickness (CRT) was measured with automated software. The vessel densities in the SCP and DCP were compared between different groups using SPSS. Results. A total of 25 eyes of 25 healthy subjects and 30 eyes of 17 patients with RP were evaluated in the study. There was no significant difference in ages between the two groups (F = 0.065 and P = 0.937 ). There was a significant difference in SCP and DCP between the patients with RP and healthy individuals ( P < 0.001 and P < 0.001 ). The DCP was significantly reduced in the parafovea region between the macular intact and defect groups P < 0.05 , except in the fovea and nasal regions. After linear regression, the DCP/SCP ratio in the whole, fovea, and parafovea regions was closely related to the DCP vessel density P < 0.05 , and CRT in the fovea and parafovea was not related to the whole DCP ( P = 0.186 and P = 0.539 ). Conclusion. The vessel density decreased in patients with RP, especially in the DCP of the parafovea region. A greater loss of capillaries in the DCP was found when the macular region was involved. The DCP/SCP ratio may be an important indicator of RP.

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Repeatability of ocular surface vessel density measurements with optical coherence tomography angiography

BMC Ophthalmology ◽

10.1186/s12886-019-1255-2 ◽

2019 ◽

Vol 19 (1) ◽

Author(s):

Sijie Cai ◽

Fengping Zhao ◽

Chixin Du

Keyword(s):

Optical Coherence Tomography ◽

Ocular Surface ◽

Optical Coherence Tomography Angiography ◽

Imaging System ◽

Intraclass Correlation ◽

Vessel Density ◽

Optical Coherence ◽

Significant Difference ◽

Surface Vessel ◽

Healthy Eyes

Abstract Background To determine the repeatability of measurements of ocular surface vessel density in normal and diseased eyes using optical coherence tomography angiography (OCTA). Methods Ten normal eyes, 10 pinguecula eyes, and 10 pterygium eyes of 30 volunteers were subjected to OCTA (AngioVue Imaging System, Optovue, Inc.). For scanning, we used the corneal adapter module. Each eye was scanned three times in the nasal and temporal directions, separately. AngioVue software was used to generate the ocular surface vessel density. Ocular surface vessel density was defined as the proportion of vessel area with blood flow to the total measurement area (3 × 3 mm2). Intersession repeatability of the measurement was summarized as the coefficient of variation (CV), and intraclass correlation coefficients (ICC) were calculated by variance component models. Results The CVs were less than 5% in all subjects, and the ICCs exceeded 0.9; thus, all measurements showed good repeatability. The nasal vessels densities differed significantly between healthy eyes and eyes with pterygium (P < 0.05); however, there was no significant difference between healthy eyes and eyes with pinguecula (P = 0.466). Conclusions These results suggest that measurement of ocular surface vessel density by OCTA in normal eyes and eyes with pterygium and pinguecula is repeatable. This preliminary research describes a quantitative and visual method for assessing vessel density of the ocular surface with a high level of consistency.

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Diagnostic performance of optical coherence tomography angiography in glaucoma: a systematic review and meta-analysis

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2018-313461 ◽

2019 ◽

Vol 103 (11) ◽

pp. 1677-1684 ◽

Cited By ~ 3

Author(s):

Ana I M Miguel ◽

André B Silva ◽

Luis F Azevedo

Keyword(s):

Systematic Review ◽

Optical Coherence Tomography ◽

Prospective Studies ◽

Diagnostic Performance ◽

Optical Coherence Tomography Angiography ◽

Meta Analysis ◽

Optical Coherence ◽

Manual Search ◽

Significant Difference ◽

The Mean

BackgroundCompared with current imaging methods, the diagnostic performance and the advantages and limitations of optical coherence tomography angiography (OCTA) remain unclear. We performed a systematic review and meta-analysis of studies investigating vessel density (VD) in patients with glaucoma using OCTA.MethodsWe conducted a literature search on PubMed, Scopus, Web of Science, ISI Conference Proceedings and Google Scholar, along with a manual search, from January 2006 to March 2018. We included prospective studies that used OCTA to compare the VD in glaucomatous eyes with healthy control eyes.ResultsOf 3045 screened articles, 24 were included in a broad characterisation and 18 in the meta-analysis. We observed a statistically significant reduction in the mean peripapillary VD (MPVD) in glaucoma (MPVD: 57.53%, 95% CI 52.60 to 62.46, p< 0.001) compared with controls (MPVD: 65.47%, 95% CI 59.82 to 71.11; standardised mean difference [SMD], –1.41, 95% CI –1.62 to –1.20, p< 0.001) for 888 glaucomatous and 475 healthy eyes, and also in the mean-whole optic nerve image VD (SMD, –9.63, 95% CI –10.22 to –9.03, p<0.001), mean inside-disc VD (SMD, − 9.51, 95% CI –12.66 to –6.36, p<0.05) and mean parafoveal VD (SMD, –3.92, 95% CI –4.73 to –3.12, p<0.001). Subgroup analyses revealed a significant difference in the MPVD across glaucoma subtypes and OCTA devices.ConclusionThis suggests the diagnostic utility of OCTA in detecting glaucomatous eyes; however, further longitudinal prospective studies are welcomed to characterise vascular changes in glaucoma.

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Repeatability of vessel density measurements of optical coherence tomography angiography in normal and glaucoma eyes

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2017-310637 ◽

2017 ◽

Vol 102 (3) ◽

pp. 352-357 ◽

Cited By ~ 55

Author(s):

Jayasree P Venugopal ◽

Harsha L Rao ◽

Robert N Weinreb ◽

Zia S Pradhan ◽

Srilakshmi Dasari ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Repeated Measures ◽

Optical Coherence Tomography Angiography ◽

Signal Strength ◽

Cross Sectional Study ◽

Vessel Density ◽

Optical Coherence ◽

Cross Sectional ◽

Density Measurements ◽

Density Values

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.

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Peripapillary and Macular Flow Changes in Nonarteritic Anterior Ischemic Optic Neuropathy (NAION) by Optical Coherence Tomography Angiography (OCT-A)

Journal of Ophthalmology ◽

10.1155/2020/3010631 ◽

2020 ◽

Vol 2020 ◽

pp. 1-8

Author(s):

Juejun Liu ◽

Changzheng Chen ◽

Lu Li ◽

Zuohuizi Yi ◽

Hongmei Zheng

Keyword(s):

Optical Coherence Tomography ◽

Optic Neuropathy ◽

Optical Coherence Tomography Angiography ◽

Vessel Density ◽

Anterior Ischemic Optic Neuropathy ◽

Ischemic Optic Neuropathy ◽

Optical Coherence ◽

Significant Difference ◽

Flow Changes ◽

Sd Oct

Background. To analyze the blood flow changes of radial peripapillary capillaries (RPCs) and macula with time procession in patients with nonarteritic anterior ischemic optic neuropathy (NAION) by optical coherence tomography angiography (OCT-A). Methods. A total of 21 affected eyes and 19 unaffected eyes from 21 NAION patients were included. Assessments of BCVA, CFP, SD-OCT, and OCT-A were performed on NAION patients at enrollment and at 1-2 weeks, 1-2 months, and 3–6 months after enrollment. Measures of the thickness of the peripapillary retinal nerve fiber layer (wRNFL) and macular ganglion cell complex (wGCC) of the whole image in SD-OCT, vessel density of the RPC (wRPC) and superficial and deep vascular complexes (wSVD, wDVD) in the whole image of OCT-A, and their superior- and inferior-hemi values (s/iRNFL, s/iGCC, s/iRPC, and s/iSVD) were assessed. Results. Compared to unaffected control eyes, wRPC ( p ≤ 0.001 ) was significantly lower in affected eyes at baseline, and there was no significant difference in wSVD ( p > 0.05 ). The wRPC and wSVD values of affected eyes were significantly decreased at follow-up time points of 1–2 and 3–6 months compared to baseline ( p = 0.001 , p ≤ 0.001 ; p ≤ 0.001 , p ≤ 0.001 ). The sRPC values were significantly lower than iRPC at 1-2/3–6 months ( p = 0.016 , p = 0.013 ), and sSVD values were lower than iSVD at 1-2 months ( p = 0.010 ). Statistically significant correlations were found between wRPC and wRNFL values at 3–6 months (r = 0.626, p = 0.022 ), between wSVD and wGCC at 1-2 weeks and 1-2 months (r = 0.570, r = 0.436; p = 0.007 , p = 0.048 ). Conclusion. OCT-A revealed a sectorial reduction in vessel density in the RPC and macula with the disease progression of NAION from acute to atrophic stages, a classification associated with structural deficits.

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Vessel density analysis in patients with retinitis pigmentosa by means of optical coherence tomography angiography

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2016-308925 ◽

2016 ◽

Vol 101 (4) ◽

pp. 428-432 ◽

Cited By ~ 58

Author(s):

Maurizio Battaglia Parodi ◽

Maria Vittoria Cicinelli ◽

Alessandro Rabiolo ◽

Luisa Pierro ◽

Marco Gagliardi ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Retinitis Pigmentosa ◽

Optical Coherence Tomography Angiography ◽

Vessel Density ◽

Optical Coherence ◽

Density Analysis

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Quantifying the pattern of retinal vascular orientation in diabetic retinopathy using optical coherence tomography angiography

Scientific Reports ◽

10.1038/s41598-021-95219-9 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Yanhui Ma ◽

Matthew P. Ohr ◽

Xueliang Pan ◽

Cynthia J. Roberts

Keyword(s):

Optical Coherence Tomography ◽

Diabetic Retinopathy ◽

Optical Coherence Tomography Angiography ◽

Preferred Orientation ◽

Vessel Density ◽

Optical Coherence ◽

Vessel Area ◽

Retinal Microvasculature ◽

Significant Difference ◽

Orientation Pattern

AbstractQuantitative imaging using optical coherence tomography angiography (OCTA) could provide objective tools for the detection and characterization of diabetic retinopathy (DR). In this study, an operator combining the second derivative and Gaussian multiscale convolution is applied to identify the retinal orientation at each pixel in the OCTA image. We quantified the pattern of retinal vascular orientation and developed three novel quantitative metrics including vessel preferred orientation, vessel anisotropy, and vessel area. Each of eight 45º sectors of the circular disk centered at the macular region was defined as the region of interest. Significant sectoral differences were observed in the preferred orientation (p < 0.0001) and vessel area (p < 0.0001) in the 34 healthy subjects, whereas vessel anisotropy did not demonstrate a significant difference among the eight sectors (p = 0.054). Differential retinal microvascular orientation patterns were observed between healthy controls (n = 34) and the DR subjects (n = 7). The vessel area characterized from the vascular orientation pattern was shown to be strongly correlated with the traditionally reported vessel density (Pearson R > 0.97, p < 0.0001). With three metrics calculated from the vascular orientation pattern simultaneously and sectorally, our quantitative assessment for retinal microvasculature provides more information than vessel density alone and thereby may enhance the detection of DR. These preliminary results suggest the feasibility and advantage of our vessel orientation-based quantitative approach using OCTA to characterize DR-associated changes in retinal microvasculature.

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Follow-up of nonarteritic anterior ischemic optic neuropathy with optical coherence tomography angiography

10.21203/rs.2.20693/v1 ◽

2020 ◽

Author(s):

Juejun Liu ◽

Changzheng Chen ◽

Li Lu ◽

Zuohuizi Yi ◽

Hongmei Zheng

Keyword(s):

Optical Coherence Tomography ◽

Optic Neuropathy ◽

Optical Coherence Tomography Angiography ◽

Vessel Density ◽

Anterior Ischemic Optic Neuropathy ◽

Ischemic Optic Neuropathy ◽

Optical Coherence ◽

Significant Difference ◽

Sd Oct

Abstract Background To analyze the blood flow changes of radial peripapillary capillaries (RPC) and macula with time procession in patients with non-arteritic anterior ischemic optic neuropathy (NAION) using optical coherence tomography angiography (OCT-A).Methods A total of 21 affected eyes and 19 unaffected eyes from 21 NAION patients, and 40 eyes of 20 healthy individuals were included. Assessments of BCVA, CFP, SD-OCT, and OCT-A were performed on NAION patients at enrollment and at 1-2 weeks, 1-2 months, and 3-6 months post-enrollment. Measures of the thickness of peripapillary retinal nerve fiber layer (wRNFL) and macular ganglion cell complex (wGCC) of the whole image in SD-OCT, vessel density of RPC (wRPC) and superficial and deep vascular complexes (wSVD, wDVD) in the whole image of OCT-A, and their superior- and inferior-hemi values (s/iRNFL, s/iGCC, s/iRPC, and s/iSVD) were assessed.Results Compared to healthy controls, wRPC (p<0.001) and wDVD (P=0.001) were significantly lower in affected eyes at baseline, and there was no significant difference in wSVD (p>0.05). The wRPC and wSVD values of affected eyes were significantly decreased at follow-up time points of 1-2 and 3-6 months compared to baseline (p=0.001, p=0.000; p=0.000, p=0.000). The sRPC values were significantly lower than iRPC at 1-2/3-6 months (p=0.001, p=0.000), and sSVD values were lower than iSVD at 1-2 months (p=0.010). Statistically significant correlations were found between wRPC and wRNFL values at 3-6 months (r=0.626, p=0.022), between wSVD and wGCC at 1-2 weeks and 1-2 months (r=0.570, r=0.436; p=0.007, p=0.048).Conclusion OCT-A revealed a sectorial reduction in vessel density in RPC and macula with the disease progression of NAION from acute to atrophic stages, a classification associated with structural deficits.

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Assessment of the retinal vasculature in healthy Chinese preschool children aged 4–6 years old using optical coherence tomography angiography

BMC Ophthalmology ◽

10.1186/s12886-021-02154-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Lu Xiang ◽

Yingming Zhou ◽

Yanwei Chen ◽

Siyu Jiang ◽

Chunli Fei ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Preschool Children ◽

Optic Disc ◽

Optical Coherence Tomography Angiography ◽

Vessel Density ◽

Retinal Vasculature ◽

Optical Coherence ◽

Significant Difference ◽

Capillary Plexus ◽

The Mean

Abstract Purpose To establish normal parameters of macular and optic disc vasculature by optical coherence tomography angiography (OCTA) in healthy preschool children aged 4–6 years old in China. OCTA reflects retinal metabolism and development in children at these ages and could be used clinically and in future studies to aid diagnosis and prediction of retinal abnormalities and developmental stagnation. Methods In this cross-sectional study, we measured foveal, parafoveal, and perifoveal vessel density in the superficial capillary plexus (SCP); the deep capillary plexus (DCP), the foveal avascular zone (FAZ), and the radial capillary peripapillary (RPC) in the optic disc using investigational spectral-domain OCTA. The magnification effect of the FAZ area and microvasculature measurements was corrected by Littman and the modified Bennett formula. Results A total of 242 eyes (116 males and 126 females, 5.31 ± 0.73 years) were recruited for the analysis. The mean macular vessel density was 48.10 ± 2.92% and 48.74 ± 6.51% in the SCP and the DCP, respectively. The RPC vessel density was 47.17 ± 2.52%, 47.99 ± 4.48%, and 48.41 ± 3.07% in the whole image, inside disc, and peripapillary, respectively; and the mean FAZ area was 0.28 ± 0.11 mm2. A significant difference between male and female participants was found in the retinal vasculature (DCP, SCP, and RPC). None of these parameters were significantly different in age (P > 0.05), except that DCP slightly increased with aging. The right and left eyes had good consistency in the parameters of the macula and optic disc. Conclusions Our study establishes the macular and optic disc OCTA reference values in 4- to 6-year-old healthy preschool children. They may be used in longitudinal OCTA studies and clinical applications.

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