TY - JOUR
T1 - Projection-Resolved Optical Coherence Tomography Angiography of the Peripapillary Retina in Glaucoma
AU - Liu, Liang
AU - Edmunds, Beth
AU - Takusagawa, Hana
AU - Tehrani, Shandiz
AU - Lombardi, Lorinna
AU - Morrison, John C.
AU - Jia, Yali
AU - Huang, David
N1 - Funding Information:
All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported. Funding/Support: Supported by US National Institutes of Health grants R01 EY023285, R01 EY010145, and P30 EY010572; by unrestricted departmental funding from Research to Prevent Blindness (New York, NY); and by the Champalimaud Foundation (Lisbon, Portugal). The sponsor or funding organization had no role in the design or conduct of this research. Financial Disclosure: Doctors Jia and Huang have a financial interest in Optovue, Inc. These potential conflicts of interest have been reviewed and are managed by OHSU. The other authors do not report any potential financial conflicts of interest.
Funding Information:
All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported. Funding/Support: Supported by US National Institutes of Health grants R01 EY023285 , R01 EY010145 , and P30 EY010572 ; by unrestricted departmental funding from Research to Prevent Blindness (New York, NY); and by the Champalimaud Foundation (Lisbon, Portugal). The sponsor or funding organization had no role in the design or conduct of this research. Financial Disclosure: Doctors Jia and Huang have a financial interest in Optovue, Inc. These potential conflicts of interest have been reviewed and are managed by OHSU. The other authors do not report any potential financial conflicts of interest.
Publisher Copyright:
© 2019 Elsevier Inc.
PY - 2019/11
Y1 - 2019/11
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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U2 - 10.1016/j.ajo.2019.05.024
DO - 10.1016/j.ajo.2019.05.024
M3 - Article
C2 - 31170389
AN - SCOPUS:85069436033
VL - 207
SP - 99
EP - 109
JO - American Journal of Ophthalmology
JF - American Journal of Ophthalmology
SN - 0002-9394
ER -