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Abstract #81216 Published in IGR 20-3
Projection-Resolved Optical Coherence Tomography Angiography of the Peripapillary Retina in Glaucoma
Liu L; Edmunds B; Takusagawa H; Tehrani S; Lombardi L; Morrison JC; Jia Y; Huang DAmerican Journal of Ophthalmology 2019; 207: 99-109
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 plexuses 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 the other slabs. The NFLP, SVC and all-plexus CD in the glaucoma group were significantly lower (P <0.001) than the normal group, but no significant differences in GCLP-CD and DVC-CD appeared between the two 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 coefficient = 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 the deeper layers. Reflectance-compensated CD and VD parameters for both NFLP and SVC could be useful in the clinical management of glaucoma.
Casey Eye Institute and Department of Ophthalmology, Oregon Health and Science University, Portland, Oregon, USA.
Full articleClassification:
6.9.2.2 Posterior (Part of: 6 Clinical examination methods > 6.9 Computerized image analysis > 6.9.2 Optical coherence tomography)
6.13 Provocative tests (Part of: 6 Clinical examination methods)
2.13 Retina and retinal nerve fibre layer (Part of: 2 Anatomical structures in glaucoma)
