Optical Coherence Tomography Angiography of Optic Disc Perfusion in Glaucoma

Yali Jia, Eric Wei, Xiaogang Wang, Xinbo Zhang, John C. Morrison, Mansi Parikh, Lori H. Lombardi, Devin M. Gattey, Rebecca L. Armour, Beth Edmunds, Martin F. Kraus, James G. Fujimoto (+1 others)
<span title="">2014</span> <i title="Elsevier BV"> <a target="_blank" rel="noopener" href="https://fatcat.wiki/container/huzqbmgsqzcy7jjzbdrxcbbxgy" style="color: black;">Ophthalmology (Rochester, Minn.)</a> </i> &nbsp;
Purpose-To compare optic disc perfusion between normal and glaucoma subjects using optical coherence tomography (OCT) angiography and detect optic disc perfusion changes in glaucoma. Design-Observational, cross-sectional study. Participants-Twenty-four normal subjects and 11 glaucoma patients were included. Methods-One eye of each subject was scanned by a high-speed 1050 nm wavelength sweptsource OCT instrument. The split-spectrum amplitude-decorrelation angiography algorithm (SSADA) was used
more &raquo; ... compute three-dimensional optic disc angiography. A disc flow index was computed from four registered scans. Confocal scanning laser ophthalmoscopy (cSLO) was used to measure disc rim area, and stereo photography was used to evaluate cup/disc ratios. Wide field OCT scans over the discs were used to measure retinal nerve fiber layer (NFL) thickness. Main Outcome Measurements-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 between 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 glaucoma subjects. 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 (R 2 = 0.752, p = 0.001). These correlations were significant even after accounting for age, cup/disc area ratio, NFL, and rim area. Conclusions-OCT angiography, generated by the new SSADA algorithm, repeatably measures optic disc perfusion. OCT angiography could be useful in the evaluation of glaucoma and glaucoma progression. Glaucoma is the second leading cause of blindness in the United States. 1, 2 Although elevated intraocular pressure (IOP) is a risk factor, over half of glaucoma patients actually have IOPs within the normal range at their first visit. 3 There is a growing body of evidence suggesting that glaucoma pathogenesis is related to vascular dysfunction. 2, 4-6 More recently, prospective trials have demonstrated that optic disc hemorrhage 6-11 and peripapillary atrophy 12-14 are both associated with accelerated glaucoma progression. These findings may support a role for focal ischemia of the optic disc as a causative factor for glaucoma at least in some patients, either by itself or in conjunction with elevated IOP.
<span class="external-identifiers"> <a target="_blank" rel="external noopener noreferrer" href="https://doi.org/10.1016/j.ophtha.2014.01.021">doi:10.1016/j.ophtha.2014.01.021</a> <a target="_blank" rel="external noopener" href="https://www.ncbi.nlm.nih.gov/pubmed/24629312">pmid:24629312</a> <a target="_blank" rel="external noopener" href="https://pubmed.ncbi.nlm.nih.gov/PMC4082728/">pmcid:PMC4082728</a> <a target="_blank" rel="external noopener" href="https://fatcat.wiki/release/l3ou7xcczfck7a63pr4lzmpjie">fatcat:l3ou7xcczfck7a63pr4lzmpjie</a> </span>
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