Optical coherence tomography angiography of the macula and optic nerve head: microvascular density and test-retest repeatability in normal subjects

Abstract Purpose To measure optic nerve head (ONH) blood perfusion using optical coherence tomography angiography (OCTA) at various stages of diabetic retinopathy (DR). Methods One hundred seventy six eyes of 94 patients included in this retrospective single-centre cross-sectional study. The subjects were studied in normal, no diabetic retinopathy (NDR), non-proliferative diabetic retinopathy (NPDR) and proliferative retinopathy (PDR) groups. The eyes were subjected to AngioDisc ONH imaging using OCTA for papillary (Disc) and peripapillary (RPC) vascular density (VD) evaluation. Results The mean age of the participants was 56.08 ± 8.87 years and 34 (36.2 percent) were male. With increased DR severity, a statistically significant decrease in peripapillary VD was found. The study showed that only VD of the whole RPC (W-RPC) could be a valid biomarker in the staging assessment. VD of RPC, in all subsections, was considerably different from normal cases in the PDR group. Visual acuity was correlated with whole image ONH VD. The duration of DM, FBS, hyperlipidemia and DME had no effect on the ONH perfusion. Conclusions The study showed that only the W-RPC VD could be a reasonable marker in the staging assessment. VDs assessed by OCTA can be useful for assessing and tracking early ONH changes in DR patients.

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

European Journal of Ophthalmology ◽

10.1177/1120672119834472 ◽

2019 ◽

Vol 30 (4) ◽

pp. 756-763 ◽

Cited By ~ 7

Author(s):

José Ignacio Fernández-Vigo ◽

Bachar Kudsieh ◽

Ana Macarro-Merino ◽

Pedro Arriola-Villalobos ◽

José María Martínez-de-la-Casa ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Optic Nerve ◽

Optic Nerve Head ◽

Optical Coherence Tomography Angiography ◽

Central Zone ◽

Vessel Density ◽

Optical Coherence ◽

Outer Retina ◽

Swept Source ◽

Capillary Plexus

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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