Optical coherence tomography angiography of optic disc perfusion in glaucoma.

By Yali Jia, Eric T. Wei, Xiaogang Wang, Xinbo Zhang, J. Morrison, M. Parikh, Lorinna Lombardi, D. Gattey, R. Armour, B. Edmunds and 3 more. Ophthalmology (Rochester, Minn.), 2014

723 citations recorded by the source corpus.

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 (R(2) = 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.

Subfields: Biomedical Engineering, Ophthalmology, Radiology, Nuclear Medicine and Imaging

View Paper: https://www.semanticscholar.org/paper/e5f865bbd8c87858cb021c66938953487c3504e3

How researchers see this paper

The researchers whose trusted networks rank it highest, strongest advocate first. Every researcher gets a different order.

In Biomedical Engineering

1. James G. Fujimoto
2. Michael A. D. Taylor
3. Warwick P. Bowen

In Ophthalmology

1. Yali Jia
2. Joachim Hornegger
3. James G. Fujimoto

In Radiology, Nuclear Medicine and Imaging

1. Joachim Hornegger
2. James G. Fujimoto

Citations in the corpus

• Optical Coherence Tomography Angiography (2016, background): “Initial studies suggest that these metrics can have good repeatability and reproducibility.(71,102,103) To more directly assess capillary dropout and neovascularization, however, additional metrics have been investigated.”
• Quantitative optical coherence tomography angiography of choroidal neovascularization in age-related macular degeneration (2014, methodology): “By using decorrelation instead of variance of reflected signal to measure flow, the measurement is largely independent of OCT signal strength level over a wide range.(28,45) This is important because previous techniques, such as laser Doppler flowmetry (e.”
• Quantitative optical coherence tomography angiography of vascular abnormalities in the living human eye (2015, methodology): “The first was a custombuilt swept-source OCT instrument (14, 24, 42, 43).”
• Optical coherence tomography angiography: A comprehensive review of current methods and clinical applications (2017, background): “They demonstrated that multiple sclerosis patients with a history of optic neuritis had a reduced disc flow index compared to patients with multiple sclerosis that did not have an optic neuritis history as well as normal controls (Wang, Jia et al. 2014).”