Projection-Resolved Optical Coherence Tomography Angiography of the Peripapillary Retina in Glaucoma

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Abstract

Purpose: To detect plexus-specific peripapillary retinal perfusion defects in glaucoma, using projection-resolved optical coherence tomography angiography (PR-OCTA). Design: Prospective cross-sectional study. Methods: One eye each of 45 perimetric glaucoma participants and 37 age-matched normal participants were scanned using 4.5-mm OCTA scans centered on the disc. The PR-OCTA algorithm removed flow projection artifacts in OCT angiograms. Five en face OCTA slabs were analyzed: nerve fiber layer plexus (NFLP), ganglion cell layer plexus (GCLP), superficial vascular complex (SVC [NFLP + GCLP]), deep vascular complex (DVC), and all plexi combined. Peripapillary retinal capillary density (CD) and vessel density (VD) were calculated using a reflectance-compensated algorithm. Results: Focal capillary dropout could be visualized more clearly in the NFLP than in the other slabs. The NFLP, SVC, and all-plexus CD in the glaucoma group were significantly lower (P < 0.001) than in the normal group, but no significant differences in GCLP-CD and DVC-CD appeared between the 2 groups. Both NFLP-CD and SVC-CD had excellent diagnostic accuracy, as measured by the area under the receiver operating characteristic curve (AROC = 0.981 and 0.976), correlation with visual field mean deviation (Pearson r = 0.819 and 0.831), and repeatability (intraclass correlation coefficients = 0.947 and 0.942). Performances of NFLP-VD and SVC-VD were similar to the corresponding CD parameters. Conclusions: In this glaucoma group, reduction in perfusion was more pronounced in superficial layers of the peripapillary retina (NFLP and SVC) than in the deeper layers. Reflectance-compensated CD and VD parameters for both NFLP and SVC could be useful in the clinical management of glaucoma.

Original languageEnglish (US)
Pages (from-to)99-109
Number of pages11
JournalAmerican journal of ophthalmology
Volume207
DOIs
StatePublished - Nov 1 2019

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Optical Coherence Tomography
Glaucoma
Nerve Fibers
Retina
Angiography
Ganglia
Blood Vessels
Perfusion
Visual Fields
ROC Curve
Artifacts
Cross-Sectional Studies

ASJC Scopus subject areas

  • Ophthalmology

Cite this

@article{266c044c67a547a6a8c2adefc454bb44,
title = "Projection-Resolved Optical Coherence Tomography Angiography of the Peripapillary Retina in Glaucoma",
abstract = "Purpose: To detect plexus-specific peripapillary retinal perfusion defects in glaucoma, using projection-resolved optical coherence tomography angiography (PR-OCTA). Design: Prospective cross-sectional study. Methods: One eye each of 45 perimetric glaucoma participants and 37 age-matched normal participants were scanned using 4.5-mm OCTA scans centered on the disc. The PR-OCTA algorithm removed flow projection artifacts in OCT angiograms. Five en face OCTA slabs were analyzed: nerve fiber layer plexus (NFLP), ganglion cell layer plexus (GCLP), superficial vascular complex (SVC [NFLP + GCLP]), deep vascular complex (DVC), and all plexi combined. Peripapillary retinal capillary density (CD) and vessel density (VD) were calculated using a reflectance-compensated algorithm. Results: Focal capillary dropout could be visualized more clearly in the NFLP than in the other slabs. The NFLP, SVC, and all-plexus CD in the glaucoma group were significantly lower (P < 0.001) than in the normal group, but no significant differences in GCLP-CD and DVC-CD appeared between the 2 groups. Both NFLP-CD and SVC-CD had excellent diagnostic accuracy, as measured by the area under the receiver operating characteristic curve (AROC = 0.981 and 0.976), correlation with visual field mean deviation (Pearson r = 0.819 and 0.831), and repeatability (intraclass correlation coefficients = 0.947 and 0.942). Performances of NFLP-VD and SVC-VD were similar to the corresponding CD parameters. Conclusions: In this glaucoma group, reduction in perfusion was more pronounced in superficial layers of the peripapillary retina (NFLP and SVC) than in the deeper layers. Reflectance-compensated CD and VD parameters for both NFLP and SVC could be useful in the clinical management of glaucoma.",
author = "Liang Liu and Edmunds, {Lorna (Beth)} and Hana Takusagawa and Shandiz Tehrani and Lorinna Lombardi and John Morrison and Jia Yali and David Huang",
year = "2019",
month = "11",
day = "1",
doi = "10.1016/j.ajo.2019.05.024",
language = "English (US)",
volume = "207",
pages = "99--109",
journal = "American Journal of Ophthalmology",
issn = "0002-9394",
publisher = "Elsevier USA",

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TY - JOUR

T1 - Projection-Resolved Optical Coherence Tomography Angiography of the Peripapillary Retina in Glaucoma

AU - Liu, Liang

AU - Edmunds, Lorna (Beth)

AU - Takusagawa, Hana

AU - Tehrani, Shandiz

AU - Lombardi, Lorinna

AU - Morrison, John

AU - Yali, Jia

AU - Huang, David

PY - 2019/11/1

Y1 - 2019/11/1

N2 - Purpose: To detect plexus-specific peripapillary retinal perfusion defects in glaucoma, using projection-resolved optical coherence tomography angiography (PR-OCTA). Design: Prospective cross-sectional study. Methods: One eye each of 45 perimetric glaucoma participants and 37 age-matched normal participants were scanned using 4.5-mm OCTA scans centered on the disc. The PR-OCTA algorithm removed flow projection artifacts in OCT angiograms. Five en face OCTA slabs were analyzed: nerve fiber layer plexus (NFLP), ganglion cell layer plexus (GCLP), superficial vascular complex (SVC [NFLP + GCLP]), deep vascular complex (DVC), and all plexi combined. Peripapillary retinal capillary density (CD) and vessel density (VD) were calculated using a reflectance-compensated algorithm. Results: Focal capillary dropout could be visualized more clearly in the NFLP than in the other slabs. The NFLP, SVC, and all-plexus CD in the glaucoma group were significantly lower (P < 0.001) than in the normal group, but no significant differences in GCLP-CD and DVC-CD appeared between the 2 groups. Both NFLP-CD and SVC-CD had excellent diagnostic accuracy, as measured by the area under the receiver operating characteristic curve (AROC = 0.981 and 0.976), correlation with visual field mean deviation (Pearson r = 0.819 and 0.831), and repeatability (intraclass correlation coefficients = 0.947 and 0.942). Performances of NFLP-VD and SVC-VD were similar to the corresponding CD parameters. Conclusions: In this glaucoma group, reduction in perfusion was more pronounced in superficial layers of the peripapillary retina (NFLP and SVC) than in the deeper layers. Reflectance-compensated CD and VD parameters for both NFLP and SVC could be useful in the clinical management of glaucoma.

AB - Purpose: To detect plexus-specific peripapillary retinal perfusion defects in glaucoma, using projection-resolved optical coherence tomography angiography (PR-OCTA). Design: Prospective cross-sectional study. Methods: One eye each of 45 perimetric glaucoma participants and 37 age-matched normal participants were scanned using 4.5-mm OCTA scans centered on the disc. The PR-OCTA algorithm removed flow projection artifacts in OCT angiograms. Five en face OCTA slabs were analyzed: nerve fiber layer plexus (NFLP), ganglion cell layer plexus (GCLP), superficial vascular complex (SVC [NFLP + GCLP]), deep vascular complex (DVC), and all plexi combined. Peripapillary retinal capillary density (CD) and vessel density (VD) were calculated using a reflectance-compensated algorithm. Results: Focal capillary dropout could be visualized more clearly in the NFLP than in the other slabs. The NFLP, SVC, and all-plexus CD in the glaucoma group were significantly lower (P < 0.001) than in the normal group, but no significant differences in GCLP-CD and DVC-CD appeared between the 2 groups. Both NFLP-CD and SVC-CD had excellent diagnostic accuracy, as measured by the area under the receiver operating characteristic curve (AROC = 0.981 and 0.976), correlation with visual field mean deviation (Pearson r = 0.819 and 0.831), and repeatability (intraclass correlation coefficients = 0.947 and 0.942). Performances of NFLP-VD and SVC-VD were similar to the corresponding CD parameters. Conclusions: In this glaucoma group, reduction in perfusion was more pronounced in superficial layers of the peripapillary retina (NFLP and SVC) than in the deeper layers. Reflectance-compensated CD and VD parameters for both NFLP and SVC could be useful in the clinical management of glaucoma.

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