The Diagnostic Value of Pulsar Perimetry, Optical Coherence Tomography, and Optical Coherence Tomography Angiography in Pre-Perimetric and Perimetric Glaucoma

The purpose of this article is to investigate the diagnostic value of Pulsar perimetry (PP), optical coherence tomography (OCT), and optical coherence tomography angiography (OCTA) in pre-perimetric glaucoma (PPG) and perimetric glaucoma (PG). This retrospective cross-sectional study included 202 eyes (145 eyes in the control group, 40 eyes in the PPG group, and 17 eyes in the PG group) from 105 subjects. The results were analyzed by paired t-tests and Wilcoxon signed-rank test. The area under the curve (AUC), sensitivity, and specificity were used to evaluate the diagnostic accuracy. Pearson correlation was used to investigate the relationships of each parameter. The most sensitive parameters for differentiating the control group from the PPG group by using Pulsar, OCT, and OCTA were square loss variance of PP (AUC = 0.673, p < 0.001), superior ganglion cell complex thickness (AUC = 0.860, p < 0.001), and superior-hemi retina thickness (AUC = 0.817, p < 0.001). In the PG group, the most sensitive parameters were mean defect of PP (AUC = 0.885, p < 0.001), whole image of ganglion cell complex thickness (AUC = 0.847, p < 0.001), and perifoveal retina thickness (AUC = 0.833, p < 0.001). The mean defect of PP was significantly correlated with vascular parameters (radial peripapillary capillary (RPC), p = 0.008; vessel density of macular superficial vascular complex (VDms), p = 0.001; vessel density of macular deep vascular complex (VDmd), p = 0.002). In conclusion, structural measurements using OCT were more sensitive than vascular measurements of OCTA and functional measurements of PP for PPG, while PP was more sensitive than the structural and vascular measurements for PG. The mean defect of PP was also shown to be highly correlated with the reduction of vessel density.

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Characterisation of macular superficial vessel density alteration in preclinical ethambutol-induced optic neuropathy using optical coherence tomography angiography

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2020-317742 ◽

2020 ◽

pp. bjophthalmol-2020-317742

Author(s):

Lingya Su ◽

Qiushi Li ◽

Liwei Zhu ◽

Shuangqing Wu ◽

Xiaotong Sha ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Normal Control ◽

Optic Neuropathy ◽

Optical Coherence Tomography Angiography ◽

Vessel Density ◽

Control Group ◽

Inner Plexiform Layer ◽

Optical Coherence ◽

Control Groups ◽

The Mean

AimTo investigate the changes in macular vessel density (mVD) and its relationship to macular ganglion cell–inner plexiform layer (mGCIPL) thickness in patients receiving ethambutol (EMB) therapy for tuberculosis without recognisable clinical symptoms or signs of EMB-induced optic neuropathy (EON).MethodsA total of 23 eyes of 13 patients using EMB therapy for 6 months without EON (preclinical EON) as the EMB group, 40 eyes of 23 healthy individuals as the normal control group and 18 eyes of 10 patients with tuberculosis before receiving EMB therapy as the blank control group were retrospectively analysed. The mean peripapillary retinal nerve fibre layer (pRNFL) and mGCIPL thicknesses and mVD were measured using optical coherence tomography angiography. Patients in the EMB group were compared with individuals in the normal and blank control groups, and changes in macular parameters were evaluated.ResultsCentral circle mVD (cCVD) was significantly lower in the EMB group than in both control groups (generalised estimating equation (GEE), p=0.003 and 0.029, respectively). The mGCIPL thickness in all regions and the mean pRNFL thickness were not significantly different between the EMB group and both control groups (GEE, p=1.000 for all). There were no significant differences in mVD, mGCIPL thickness and mean pRNFL thickness between the normal control and blank control groups (p>0.05). In the generalised linear model analyses, the minimum and inferonasal mGCIPL thicknesses were positively correlated with cCVD in the EMB group (β=1.285, p=0.003 and β=0.770, p=0.024, respectively).ConclusionscCVD decreased with no changes in mGCIPL and mean pRNFL thicknesses in patients with preclinical EON. The minimum and inferonasal mGCIPL thicknesses were positively correlated with cCVD. cCVD might be an early indicator for monitoring early-stage EMB toxicity.

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The Role of Optical Coherence Tomography Angiography in Moderate and Advanced Primary Open-Angle Glaucoma

10.21203/rs.3.rs-710633/v1 ◽

2021 ◽

Author(s):

Yadollah Eslami ◽

Sepideh Ghods ◽

Massood Mohammadi ◽

Mona Safizadeh ◽

Ghasem Fakhraie ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Optical Coherence Tomography Angiography ◽

Primary Open Angle Glaucoma ◽

Open Angle Glaucoma ◽

Vessel Density ◽

Mean Deviation ◽

Optical Coherence ◽

Open Angle ◽

The Mean ◽

Inferior Quadrant

Abstract Purpose: To evaluate the relationship between structure and function in moderate and advanced primary open-angle glaucoma (POAG) and to determine the accuracy of structure and vasculature for discriminating moderate from advanced POAG.Methods: In this cross-sectional study 25 eyes with moderate and 40 eyes with advanced POAG were enrolled. All eyes underwent measurement of the thickness of circumpapillary retinal nerve fiber layer (cpRNFL) and macular ganglion cell complex (GCC), and optical coherence tomography angiography (OCTA) of the optic nerve head (ONH) and macula. Visual field (VF) was evaluated by Swedish interactive threshold algorithm and 24-2 and 10-2 patterns. The correlation between structure and vasculature and the mean deviation (MD) of the VFs was evaluated by a partial correlation coefficient. The area under the receiver operating characteristic curve (AUC) was applied for assessing the power of variables for discrimination moderate from advanced POAG.Results: Superior cpRNFL, superior GCC, whole image vessel density (wiVD) of the ONH area, and vessel density in inferior quadrant of perifovea had the strongest correlation with the mean deviation (MD) of the VF 24-2 (r= .351, .558, .649 and .397; p< .05). The greatest AUCs belonged to inferior cpRNFL (.789), superior GCC (.818), vessel density of the inferior hemifield of ONH area (.886), and vessel density in inferior quadrant of perifovea (.833) without statistically significant difference in pairwise comparison.Conclusion: Vasculature has a stronger correlation than the structure with MD in moderate and advanced POAG and is as accurate as structure in discrimination moderate from advanced POAG.

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The evaluation of juvenile ocular hypertension by optical coherence tomography angiography

10.21203/rs.2.24499/v1 ◽

2020 ◽

Author(s):

Xiaoxiao Chen ◽

Xiaolei Wang ◽

Xinxin Hu ◽

Xinghuai Sun

Keyword(s):

Optical Coherence Tomography ◽

Ocular Hypertension ◽

Optical Coherence Tomography Angiography ◽

Corneal Thickness ◽

Vessel Density ◽

Mean Deviation ◽

Ganglion Cell Complex ◽

Optical Coherence ◽

Fiber Layer ◽

Basic Study

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.

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Macular vessel density differs in multiple sclerosis and neuromyelitis optica spectrum disorder: An optical coherence tomography angiography study

PLoS ONE ◽

10.1371/journal.pone.0253417 ◽

2021 ◽

Vol 16 (6) ◽

pp. e0253417

Author(s):

Małgorzata Rogaczewska ◽

Sławomir Michalak ◽

Marcin Stopa

Keyword(s):

Multiple Sclerosis ◽

Optical Coherence Tomography ◽

Ganglion Cell ◽

Neuromyelitis Optica ◽

Optical Coherence Tomography Angiography ◽

Vessel Density ◽

Spectrum Disorder ◽

Optical Coherence ◽

Neuromyelitis Optica Spectrum Disorder ◽

Capillary Plexus

Multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD) are inflammatory and demyelinating diseases that commonly manifest with optic neuritis (ON) but differ in the pathogenic mechanism. Although it was shown that retinal vessels might alter in MS and NMOSD, a comparative study has not been reported. This study evaluated the macular vessel density in 40 MS patients, 13 NMOSD patients, and 20 controls using optical coherence tomography angiography. The vessel density of superficial capillary plexus (SCP) was significantly lower in ON eyes (MS+ON, NMOSD+ON) than in non-ON eyes (MS-ON, NMOSD-ON) and controls. The density of deep capillary plexus (DCP) was significantly increased in MS+ON and MS-ON eyes compared to healthy eyes. In NMOSD+ON and NMOSD-ON, the DCP did not remarkably differ from the control group. A significant positive correlation was noted between SCP and ganglion cell complex (GCC) thickness in MS+ON, MS-ON, and NMOSD+ON. The DCP did not significantly correlate with GCC thickness, but it increased or decreased with ganglion cell loss in MS and NMOSD, respectively. In conclusion, our findings suggest that the capillary changes in MS patients are secondary to ganglion cells’ atrophy, while vasculopathy seems to be a primary process in NMOSD patients.

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Acute macular neuroretinopathy: pathogenetic insights from optical coherence tomography angiography

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2018-312197 ◽

2018 ◽

Vol 103 (3) ◽

pp. 410-414 ◽

Cited By ~ 10

Author(s):

Giuseppe Casalino ◽

Alessandro Arrigo ◽

Francesco Romano ◽

Marion R Munk ◽

Francesco Bandello ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Optical Coherence Tomography Angiography ◽

Pigment Epithelium ◽

Retinal Pigment ◽

Vessel Density ◽

Control Group ◽

Optical Coherence ◽

Cross Sectional ◽

Swept Source ◽

Acute Macular Neuroretinopathy

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.

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Optical Coherence Tomography Angiography of Peripapillary Vessel Density in Multiple Sclerosis and Neuromyelitis Optica Spectrum Disorder: A Comparative Study

Journal of Clinical Medicine ◽

10.3390/jcm10040609 ◽

2021 ◽

Vol 10 (4) ◽

pp. 609

Author(s):

Małgorzata Rogaczewska ◽

Sławomir Michalak ◽

Marcin Stopa

Keyword(s):

Multiple Sclerosis ◽

Optical Coherence Tomography ◽

Optic Neuritis ◽

Neuromyelitis Optica ◽

Optical Coherence Tomography Angiography ◽

Vessel Density ◽

Spectrum Disorder ◽

Control Group ◽

Optical Coherence ◽

Neuromyelitis Optica Spectrum Disorder

Multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD) are demyelinating diseases of the central nervous system, which differ in the pathogenic mechanism. A common clinical presentation of both conditions is optic neuritis (ON). The study aimed to compare the radial peripapillary capillary (RPC) vessel density in MS and NMOSD patients using optical coherence tomography angiography (OCTA). A total of 40 MS patients, 13 NMOSD patients, and 20 controls were included. The average RPC vessel density was significantly lower in ON eyes (MS+ON, NMOSD+ON) than in non-ON eyes (MS−ON, NMOSD−ON) and in MS+ON, MS−ON, NMOSD+ON, and NMOSD−ON compared with the control group. In NMOSD+ON eyes, the vessel density in superior nasal, nasal superior, and inferior sectors was significantly more decreased than in MS+ON eyes. RPC reduction was also observed in inferior nasal and temporal superior sectors in MS−ON eyes compared with NMOSD−ON eyes. In conclusion, our findings indicate that optic neuritis is associated with a more significant RPC vessel density drop in NMOSD than in MS patients, and the predilection to superior and inferior sectors may be useful as a differential diagnostic marker.

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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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Repeatability of vessel density measurements using optical coherence tomography angiography in retinal diseases

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2018-312516 ◽

2018 ◽

Vol 103 (5) ◽

pp. 704-710 ◽

Cited By ~ 12

Author(s):

Min-Woo Lee ◽

Kyeung-Min Kim ◽

Hyung-Bin Lim ◽

Young-Joon Jo ◽

Jung-Yeul Kim

Keyword(s):

Optical Coherence Tomography ◽

Macular Oedema ◽

Optical Coherence Tomography Angiography ◽

Signal Strength ◽

Vessel Density ◽

Age Related Macular Degeneration ◽

Inner Plexiform Layer ◽

Retinal Diseases ◽

Optical Coherence ◽

The Mean

AimTo analyse the repeatability of vessel density (VD) measurements using optical coherence tomography angiography (OCTA) in patients with retinal diseases.MethodsTwo consecutive VD measurements using OCTA were analysed prospectively in patients with retinal diseases (diabetic macular oedema (DME), retinal vein occlusion (RVO) with macular oedema, epiretinal membrane (ERM), wet age-related macular degeneration (AMD)). The intraclass correlation coefficient (ICC), coefficient of variation (CV) and test-retest SD of VD measurements were assessed, and linear regression analyses were conducted to identify factors related to repeatability.ResultsA total of 134 eyes were analysed involving 20 eyes with DME, 44 eyes with RVO with macular oedema, 50 eyes with ERM and 20 eyes with wet AMD. The mean age was 64.9 years, and the mean best-corrected visual acuity (BCVA) was 0.24. The mean central macular thickness (CMT) was 391.6 µm, and the mean ganglion cell-inner plexiform layer (GC-IPL) thickness was 61.4 µm. In all four diseases, the ICC and CV of the full VD were 0.812 and 6.72%, respectively. Univariate analyses showed that the BCVA (B, 8.553; p=0.031), signal strength (B, −1.688; p=0.050), CMT (B, 0.019; p=0.015) and mean GC-IPL thickness (B, −0.103; p=0.001) were significant factors that affected the repeatability. Multivariate analyses of these factors showed a significant result for the GC-IPL thickness.ConclusionsMeasurements of the VD using OCTA showed relatively good repeatability for various retinal diseases. The BCVA, signal strength, CMT and GC-IPL thickness affected the repeatability, so these factors should be considered when analysing the VD.

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Repeatability and comparability of peripapillary vessel density measurements of high-density and non-high-density optical coherence tomography angiography scans in normal and glaucoma eyes

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2018-312401 ◽

2018 ◽

Vol 103 (7) ◽

pp. 949-954 ◽

Cited By ~ 10

Author(s):

Jayasree P Venugopal ◽

Harsha Laxmana Rao ◽

Robert N Weinreb ◽

Srilakshmi Dasari ◽

Mohammed Riyazuddin ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Optical Coherence Tomography Angiography ◽

Cross Sectional Study ◽

High Density ◽

Vessel Density ◽

Optical Coherence ◽

Sectional Study ◽

Limits Of Agreement ◽

Cross Sectional ◽

The Mean

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.

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Optical Coherence Tomography Angiography of The Macular Microcirculation in Acute Primary Angle Closure Treated With Phacoemulsification

10.21203/rs.3.rs-695251/v1 ◽

2021 ◽

Author(s):

Lin Fu ◽

Yau Kei Chan ◽

Jia Fang ◽

Junbo Liu ◽

Shumei Wen ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Optical Coherence Tomography Angiography ◽

Vessel Density ◽

Angle Closure ◽

Field Pattern ◽

Control Group ◽

Optical Coherence ◽

Acute Primary Angle Closure ◽

Primary Angle Closure ◽

Normal Individuals

Abstract Purpose To measure the changes of macular microcirculation in cases with unilateral acute primary angle closure (APAC) who were managed by phacoemulsification. Methods Patients with unilateral APAC and managed by phacoemulsification were enrolled. The contralateral unaffected eyes were served as fellow group, and normal individuals were recruited as control group. Optical coherence tomography angiography (OCT-A) was performed to analyse the macular whole image vessel density (wiVD) and parafoveal vessel density (pfVD). The retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) thicknesses were assessed using spectral-domain optical coherence tomography. Results A total of 36 APAC patients and 35 eyes from 35 normal individuals were recruited. In the APAC eyes, the mean wiVD (42.1% ± 3.7%) and pfVD (45.2% ± 3.8%) in the superficial layers (wiVD-SL and pfVD-SL) were both significantly reduced, compared to fellow eyes (45.7% ± 3.1%, 48.7% ±3.1%) and control eyes (44.4% ± 4.7%, 47.4% ± 5.1%) (P < 0.05). They were all statistically correlated with RNFL, GCC, visual field pattern standard deviation (PSD), and mean deviation (MD). Conclusion The macular OCT-A parameters including wiVD-SL and pfVD-SL were significantly reduced in the eyes with APAC compared the fellow unaffected eyes and normal control eyes. They were correlated well with RNFL, GCC, PSD and MD. The macular vessel density parameters may help monitor the progression of APAC.

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