Peripapillary microvasculature in the retinal nerve fiber layer in glaucoma by optical coherence tomography angiography: focal structural and functional correlations and diagnostic performance

Peripapillary microvasculature in the retinal nerve fiber layer in glaucoma by optical coherence tomography angiography: focal structural and functional correlations and diagnostic performance

Grace M Richter,1,* Beau Sylvester,1,* Zhongdi Chu,2 Bruce Burkemper,1 Ingy Madi,1 Ryuna Chang,1 Alena Reznik,1 Rohit Varma,1 Ruikang K Wang2 1Department of Ophthalmology, USC Roski Eye Institute, Keck School of Medicine of University of Southern California, Los Angeles, CA, USA; 2Department of Bio...

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Autores principales: Richter GM, Sylvester B, Chu Z, Burkemper B, Madi I, Chang R, Reznik A, Varma R, Wang RK
Formato: article
Lenguaje:EN
Publicado: Dove Medical Press 2018
Materias:
optical coherence tomography angiography
glaucoma
structure
function
microcirculation
diagnostic accuracy
Ophthalmology
RE1-994
Acceso en línea:https://doaj.org/article/a0d8bf9d253f4d7490d9c8c7a94933d7
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spelling oai:doaj.org-article:a0d8bf9d253f4d7490d9c8c7a94933d72021-12-02T03:13:26ZPeripapillary microvasculature in the retinal nerve fiber layer in glaucoma by optical coherence tomography angiography: focal structural and functional correlations and diagnostic performance1177-5483https://doaj.org/article/a0d8bf9d253f4d7490d9c8c7a94933d72018-11-01T00:00:00Zhttps://www.dovepress.com/peripapillary-microvasculature-in-the-retinal-nerve-fiber-layer-in-gla-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Grace M Richter,1,* Beau Sylvester,1,* Zhongdi Chu,2 Bruce Burkemper,1 Ingy Madi,1 Ryuna Chang,1 Alena Reznik,1 Rohit Varma,1 Ruikang K Wang2 1Department of Ophthalmology, USC Roski Eye Institute, Keck School of Medicine of University of Southern California, Los Angeles, CA, USA; 2Department of Bioengineering, University of Washington, Seattle, WA, USA *These authors contributed equally to this work Purpose: To quantify peripapillary microvasculature within the retinal nerve fiber layer (RNFL) in primary open-angle glaucoma (POAG) and normal eyes, determine association of perfusion parameters with structural and functional measures, and report diagnostic accuracy of perfusion parameters.Patients and methods: POAG and normal patients underwent 6×6 mm2 optic nerve head scans (Angioplex optical coherence tomography angiography [OCTA]; Cirrus HD-OCT 5000) and Humphrey Field Analyzer II-i 24-2 visual field (VF) testing. Prototype software performed semiautomatic segmentation to create RNFL en face images and quantified vessel area density (VAD), vessel skeleton density (VSD), and vessel complexity index (VCI) in the optic nerve head globally and focally. Generalized estimating equations models assessed association of OCTA parameters with VF mean deviation (MD) and RNFL thickness.Results: Thirty-eight POAG and 17 normal eyes were studied. Global VAD, VSD, and VCI were reduced in mild POAG vs normal (P<0.02) and moderate-severe vs mild POAG (P<0.04). Stepwise focal reductions across disease stage were demonstrated for OCTA parameters in the inferior hemisphere (P<0.05); reduction in OCTA parameters in mild POAG vs normal was demonstrated in inferior and superior quadrants (P<0.05). Reduced global VF MD was associated with reduced VAD, VSD, and VCI (P=0.0007, 0.0013, <0.0001; R2=0.449, 0.312, 0.399, respectively), and global RNFL thickness was associated with VAD, VSD, and VCI (P<0.0001; R2=0.499, 0.524, 0.542), superior and inferior hemifield MD were associated with corresponding VAD, VSD, and VCI (P≤0.001; R2 from 0.208 to 0.513). RNFL thickness in all quadrants was associated with corresponding OCTA parameters (P<0.05; R2 from 0.213 to 0.394), except temporal VAD and VCI. Area under curves for VAD, VSD, and VCI demonstrated good diagnostic ability (0.868, 0.855, 0.868; P<0.0001).Conclusion: Glaucomatous eyes showed stepwise reductions in RNFL microcirculation across severity; focal reductions in the inferior hemisphere and inferior and superior quadrants were most significant. OCTA parameters had stronger associations with structural rather than functional measures of glaucoma. Keywords: optic nerve head, segmentation, large vessel subtraction, structure, function, microcirculation, diagnostic accuracy Richter GMSylvester BChu ZBurkemper BMadi IChang RReznik AVarma RWang RKDove Medical Pressarticleoptical coherence tomography angiographyglaucomastructurefunctionmicrocirculationdiagnostic accuracyOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 12, Pp 2285-2296 (2018)
institution DOAJ
collection DOAJ
language EN
topic optical coherence tomography angiography
glaucoma
structure
function
microcirculation
diagnostic accuracy
Ophthalmology
RE1-994
spellingShingle optical coherence tomography angiography
glaucoma
structure
function
microcirculation
diagnostic accuracy
Ophthalmology
RE1-994
Richter GM
Sylvester B
Chu Z
Burkemper B
Madi I
Chang R
Reznik A
Varma R
Wang RK
Peripapillary microvasculature in the retinal nerve fiber layer in glaucoma by optical coherence tomography angiography: focal structural and functional correlations and diagnostic performance
description Grace M Richter,1,* Beau Sylvester,1,* Zhongdi Chu,2 Bruce Burkemper,1 Ingy Madi,1 Ryuna Chang,1 Alena Reznik,1 Rohit Varma,1 Ruikang K Wang2 1Department of Ophthalmology, USC Roski Eye Institute, Keck School of Medicine of University of Southern California, Los Angeles, CA, USA; 2Department of Bioengineering, University of Washington, Seattle, WA, USA *These authors contributed equally to this work Purpose: To quantify peripapillary microvasculature within the retinal nerve fiber layer (RNFL) in primary open-angle glaucoma (POAG) and normal eyes, determine association of perfusion parameters with structural and functional measures, and report diagnostic accuracy of perfusion parameters.Patients and methods: POAG and normal patients underwent 6×6 mm2 optic nerve head scans (Angioplex optical coherence tomography angiography [OCTA]; Cirrus HD-OCT 5000) and Humphrey Field Analyzer II-i 24-2 visual field (VF) testing. Prototype software performed semiautomatic segmentation to create RNFL en face images and quantified vessel area density (VAD), vessel skeleton density (VSD), and vessel complexity index (VCI) in the optic nerve head globally and focally. Generalized estimating equations models assessed association of OCTA parameters with VF mean deviation (MD) and RNFL thickness.Results: Thirty-eight POAG and 17 normal eyes were studied. Global VAD, VSD, and VCI were reduced in mild POAG vs normal (P<0.02) and moderate-severe vs mild POAG (P<0.04). Stepwise focal reductions across disease stage were demonstrated for OCTA parameters in the inferior hemisphere (P<0.05); reduction in OCTA parameters in mild POAG vs normal was demonstrated in inferior and superior quadrants (P<0.05). Reduced global VF MD was associated with reduced VAD, VSD, and VCI (P=0.0007, 0.0013, <0.0001; R2=0.449, 0.312, 0.399, respectively), and global RNFL thickness was associated with VAD, VSD, and VCI (P<0.0001; R2=0.499, 0.524, 0.542), superior and inferior hemifield MD were associated with corresponding VAD, VSD, and VCI (P≤0.001; R2 from 0.208 to 0.513). RNFL thickness in all quadrants was associated with corresponding OCTA parameters (P<0.05; R2 from 0.213 to 0.394), except temporal VAD and VCI. Area under curves for VAD, VSD, and VCI demonstrated good diagnostic ability (0.868, 0.855, 0.868; P<0.0001).Conclusion: Glaucomatous eyes showed stepwise reductions in RNFL microcirculation across severity; focal reductions in the inferior hemisphere and inferior and superior quadrants were most significant. OCTA parameters had stronger associations with structural rather than functional measures of glaucoma. Keywords: optic nerve head, segmentation, large vessel subtraction, structure, function, microcirculation, diagnostic accuracy 
format article
author Richter GM
Sylvester B
Chu Z
Burkemper B
Madi I
Chang R
Reznik A
Varma R
Wang RK
author_facet Richter GM
Sylvester B
Chu Z
Burkemper B
Madi I
Chang R
Reznik A
Varma R
Wang RK
author_sort Richter GM
title Peripapillary microvasculature in the retinal nerve fiber layer in glaucoma by optical coherence tomography angiography: focal structural and functional correlations and diagnostic performance
title_short Peripapillary microvasculature in the retinal nerve fiber layer in glaucoma by optical coherence tomography angiography: focal structural and functional correlations and diagnostic performance
title_full Peripapillary microvasculature in the retinal nerve fiber layer in glaucoma by optical coherence tomography angiography: focal structural and functional correlations and diagnostic performance
title_fullStr Peripapillary microvasculature in the retinal nerve fiber layer in glaucoma by optical coherence tomography angiography: focal structural and functional correlations and diagnostic performance
title_full_unstemmed Peripapillary microvasculature in the retinal nerve fiber layer in glaucoma by optical coherence tomography angiography: focal structural and functional correlations and diagnostic performance
title_sort peripapillary microvasculature in the retinal nerve fiber layer in glaucoma by optical coherence tomography angiography: focal structural and functional correlations and diagnostic performance
publisher Dove Medical Press
publishDate 2018
url https://doaj.org/article/a0d8bf9d253f4d7490d9c8c7a94933d7
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