Optical coherence tomography angiography of optic disc perfusion in glaucoma

Jia Yali, Eric Wei, Xiaogang Wang, Xinbo Zhang, John Morrison, Mansi Parikh, Lorinna Lombardi, Devin M. Gattey, Rebecca L. Armour, Lorna (Beth) Edmunds, Martin F. Kraus, James G. Fujimoto, David Huang

Research output: Contribution to journalArticle

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Abstract

Purpose To compare optic disc perfusion between normal subjects and subjects with glaucoma using optical coherence tomography (OCT) angiography and to detect optic disc perfusion changes in glaucoma. Design Observational, cross-sectional study. Participants Twenty-four normal subjects and 11 patients with glaucoma were included. Methods One eye of each subject was scanned by a high-speed 1050-nm-wavelength swept-source OCT instrument. The split-spectrum amplitude-decorrelation angiography (SSADA) algorithm was used to compute 3-dimensional optic disc angiography. A disc flow index was computed from 4 registered scans. Confocal scanning laser ophthalmoscopy (cSLO) was used to measure disc rim area, and stereo photography was used to evaluate cup/disc (C/D) ratios. Wide-field OCT scans over the discs were used to measure retinal nerve fiber layer (NFL) thickness. Main Outcome Measures Variability was assessed by coefficient of variation (CV). Diagnostic accuracy was assessed by sensitivity and specificity. Comparisons between glaucoma and normal groups were analyzed by Wilcoxon rank-sum test. Correlations among disc flow index, structural assessments, and visual field (VF) parameters were assessed by linear regression. Results In normal discs, a dense microvascular network was visible on OCT angiography. This network was visibly attenuated in subjects with glaucoma. The intra-visit repeatability, inter-visit reproducibility, and normal population variability of the optic disc flow index were 1.2%, 4.2%, and 5.0% CV, respectively. The disc flow index was reduced by 25% in the glaucoma group (P = 0.003). Sensitivity and specificity were both 100% using an optimized cutoff. The flow index was highly correlated with VF pattern standard deviation (R2 = 0.752, P = 0.001). These correlations were significant even after accounting for age, C/D area ratio, NFL, and rim area. Conclusions Optical coherence tomography angiography, generated by the new SSADA, repeatably measures optic disc perfusion and may be useful in the evaluation of glaucoma and glaucoma progression.

Original languageEnglish (US)
Pages (from-to)1322-1332
Number of pages11
JournalOphthalmology
Volume121
Issue number7
DOIs
StatePublished - 2014

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Optic Disk
Optical Coherence Tomography
Glaucoma
Angiography
Perfusion
Nonparametric Statistics
Visual Fields
Nerve Fibers
Optic Flow
Sensitivity and Specificity
Ophthalmoscopy
Photography
Microvessels
Linear Models
Lasers
Cross-Sectional Studies
Outcome Assessment (Health Care)
Population

ASJC Scopus subject areas

  • Ophthalmology

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Optical coherence tomography angiography of optic disc perfusion in glaucoma. / Yali, Jia; Wei, Eric; Wang, Xiaogang; Zhang, Xinbo; Morrison, John; Parikh, Mansi; Lombardi, Lorinna; Gattey, Devin M.; Armour, Rebecca L.; Edmunds, Lorna (Beth); Kraus, Martin F.; Fujimoto, James G.; Huang, David.

In: Ophthalmology, Vol. 121, No. 7, 2014, p. 1322-1332.

Research output: Contribution to journalArticle

Yali, Jia ; Wei, Eric ; Wang, Xiaogang ; Zhang, Xinbo ; Morrison, John ; Parikh, Mansi ; Lombardi, Lorinna ; Gattey, Devin M. ; Armour, Rebecca L. ; Edmunds, Lorna (Beth) ; Kraus, Martin F. ; Fujimoto, James G. ; Huang, David. / Optical coherence tomography angiography of optic disc perfusion in glaucoma. In: Ophthalmology. 2014 ; Vol. 121, No. 7. pp. 1322-1332.
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abstract = "Purpose To compare optic disc perfusion between normal subjects and subjects with glaucoma using optical coherence tomography (OCT) angiography and to detect optic disc perfusion changes in glaucoma. Design Observational, cross-sectional study. Participants Twenty-four normal subjects and 11 patients with glaucoma were included. Methods One eye of each subject was scanned by a high-speed 1050-nm-wavelength swept-source OCT instrument. The split-spectrum amplitude-decorrelation angiography (SSADA) algorithm was used to compute 3-dimensional optic disc angiography. A disc flow index was computed from 4 registered scans. Confocal scanning laser ophthalmoscopy (cSLO) was used to measure disc rim area, and stereo photography was used to evaluate cup/disc (C/D) ratios. Wide-field OCT scans over the discs were used to measure retinal nerve fiber layer (NFL) thickness. Main Outcome Measures Variability was assessed by coefficient of variation (CV). Diagnostic accuracy was assessed by sensitivity and specificity. Comparisons between glaucoma and normal groups were analyzed by Wilcoxon rank-sum test. Correlations among disc flow index, structural assessments, and visual field (VF) parameters were assessed by linear regression. Results In normal discs, a dense microvascular network was visible on OCT angiography. This network was visibly attenuated in subjects with glaucoma. The intra-visit repeatability, inter-visit reproducibility, and normal population variability of the optic disc flow index were 1.2{\%}, 4.2{\%}, and 5.0{\%} CV, respectively. The disc flow index was reduced by 25{\%} in the glaucoma group (P = 0.003). Sensitivity and specificity were both 100{\%} using an optimized cutoff. The flow index was highly correlated with VF pattern standard deviation (R2 = 0.752, P = 0.001). These correlations were significant even after accounting for age, C/D area ratio, NFL, and rim area. Conclusions Optical coherence tomography angiography, generated by the new SSADA, repeatably measures optic disc perfusion and may be useful in the evaluation of glaucoma and glaucoma progression.",
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T1 - Optical coherence tomography angiography of optic disc perfusion in glaucoma

AU - Yali, Jia

AU - Wei, Eric

AU - Wang, Xiaogang

AU - Zhang, Xinbo

AU - Morrison, John

AU - Parikh, Mansi

AU - Lombardi, Lorinna

AU - Gattey, Devin M.

AU - Armour, Rebecca L.

AU - Edmunds, Lorna (Beth)

AU - Kraus, Martin F.

AU - Fujimoto, James G.

AU - Huang, David

PY - 2014

Y1 - 2014

N2 - Purpose To compare optic disc perfusion between normal subjects and subjects with glaucoma using optical coherence tomography (OCT) angiography and to detect optic disc perfusion changes in glaucoma. Design Observational, cross-sectional study. Participants Twenty-four normal subjects and 11 patients with glaucoma were included. Methods One eye of each subject was scanned by a high-speed 1050-nm-wavelength swept-source OCT instrument. The split-spectrum amplitude-decorrelation angiography (SSADA) algorithm was used to compute 3-dimensional optic disc angiography. A disc flow index was computed from 4 registered scans. Confocal scanning laser ophthalmoscopy (cSLO) was used to measure disc rim area, and stereo photography was used to evaluate cup/disc (C/D) ratios. Wide-field OCT scans over the discs were used to measure retinal nerve fiber layer (NFL) thickness. Main Outcome Measures Variability was assessed by coefficient of variation (CV). Diagnostic accuracy was assessed by sensitivity and specificity. Comparisons between glaucoma and normal groups were analyzed by Wilcoxon rank-sum test. Correlations among disc flow index, structural assessments, and visual field (VF) parameters were assessed by linear regression. Results In normal discs, a dense microvascular network was visible on OCT angiography. This network was visibly attenuated in subjects with glaucoma. The intra-visit repeatability, inter-visit reproducibility, and normal population variability of the optic disc flow index were 1.2%, 4.2%, and 5.0% CV, respectively. The disc flow index was reduced by 25% in the glaucoma group (P = 0.003). Sensitivity and specificity were both 100% using an optimized cutoff. The flow index was highly correlated with VF pattern standard deviation (R2 = 0.752, P = 0.001). These correlations were significant even after accounting for age, C/D area ratio, NFL, and rim area. Conclusions Optical coherence tomography angiography, generated by the new SSADA, repeatably measures optic disc perfusion and may be useful in the evaluation of glaucoma and glaucoma progression.

AB - Purpose To compare optic disc perfusion between normal subjects and subjects with glaucoma using optical coherence tomography (OCT) angiography and to detect optic disc perfusion changes in glaucoma. Design Observational, cross-sectional study. Participants Twenty-four normal subjects and 11 patients with glaucoma were included. Methods One eye of each subject was scanned by a high-speed 1050-nm-wavelength swept-source OCT instrument. The split-spectrum amplitude-decorrelation angiography (SSADA) algorithm was used to compute 3-dimensional optic disc angiography. A disc flow index was computed from 4 registered scans. Confocal scanning laser ophthalmoscopy (cSLO) was used to measure disc rim area, and stereo photography was used to evaluate cup/disc (C/D) ratios. Wide-field OCT scans over the discs were used to measure retinal nerve fiber layer (NFL) thickness. Main Outcome Measures Variability was assessed by coefficient of variation (CV). Diagnostic accuracy was assessed by sensitivity and specificity. Comparisons between glaucoma and normal groups were analyzed by Wilcoxon rank-sum test. Correlations among disc flow index, structural assessments, and visual field (VF) parameters were assessed by linear regression. Results In normal discs, a dense microvascular network was visible on OCT angiography. This network was visibly attenuated in subjects with glaucoma. The intra-visit repeatability, inter-visit reproducibility, and normal population variability of the optic disc flow index were 1.2%, 4.2%, and 5.0% CV, respectively. The disc flow index was reduced by 25% in the glaucoma group (P = 0.003). Sensitivity and specificity were both 100% using an optimized cutoff. The flow index was highly correlated with VF pattern standard deviation (R2 = 0.752, P = 0.001). These correlations were significant even after accounting for age, C/D area ratio, NFL, and rim area. Conclusions Optical coherence tomography angiography, generated by the new SSADA, repeatably measures optic disc perfusion and may be useful in the evaluation of glaucoma and glaucoma progression.

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