OCTA vessel density changes in the macular zone in glaucomatous eyes
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To evaluate whether macular optical coherence tomography angiography (OCTA) can detect altered vessel density (VD) in the superficial and deep vascular plexus in glaucomatous eyes and to compare the diagnostic utility of the individual VD parameters.
The macular VD of 135 eyes, comprising 85 eyes diagnosed with glaucoma and 50 healthy control eyes, was examined using two OCTA devices (AngioPlex—Zeiss Meditec, Inc., Dublin, CA, USA, and AngioVue—OptoVue, Inc., Fremont, CA, USA). All study participants had neither vascular pathology, diabetes, nor vasoactive medication. The macular VD was measured at two different levels of segmentation (superficial [SL] and deep [DL] retinal vascular plexus) with a 6 × 6-mm macula scan, and VD was correlated with various structural and functional measurements. In order to test the accuracy of differentiation between eyes with and without glaucoma, we calculated the receiver operating characteristic (ROC) curve and the area under the curve (AUC).
Macular VD was significantly lower in both SL and DL in glaucomatous eyes than in healthy eyes (p = SL < 0.0001; DL = 0.009). There was no significant difference in VD between the SL and the DL (p = 6.60 · 10−18). The greatest reduction of VD in glaucomatous eyes was found in the inferior macular sector. There was no correlation of VD with age or refractive error but moderate to high correlation with intraocular pressure, time of initial diagnosis, mean deviation, ganglion cell complex, peripapillary retinal nerve fiber layer thickness, cup to disc ratio, and rim area. Among the 14 individual features of macular VD, whole VD in the SL had the best diagnostic accuracy (77.6%) as measured by the area under the ROC.
OCTA detects glaucomatous damage by measuring the macular vessel density in the superficial and deep retinal vascular plexus. It can be an additional diagnostic tool to detect glaucoma independently of the optic nerve.
KeywordsOCT angiography Glaucoma Macula Blood flow Vessel density
Compliance with ethical standards
Conflict of interest
CL lecture: Optovue, Heidelberg Engineering, Alcon. All other authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements) or non-financial interest (such as personal or professional relationships, affiliations, knowledge, or beliefs) in the subject matter or materials discussed in this manuscript.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (Ethik-Kommission - Aerztekammer Westfalen-Lippe) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- 2.Takusagawa HL, Liu L, Ma KN, et al (2017) Projection-resolved optical coherence tomography angiography of macular retinal circulation in glaucoma. Ophthalmology doi: https://doi.org/10.1016/j.ophtha.2017.06.002
- 3.Manalastas PIC, Zangwill LM, Saunders LJ, et al (2017) Reproducibility of optical coherence tomography angiography macular and optic nerve head vascular density in glaucoma and healthy eyes. J Glaucoma doi: https://doi.org/10.1097/IJG.0000000000000768
- 5.Xu H, Kong XM (2017) Study of retinal microvascular perfusion alteration and structural damage at macular region in primary open-angle glaucoma patients. Zhonghua Yan Ke Za Zhi Chin J Ophthalmol 53:98–103Google Scholar
- 6.Rao HL, Pradhan ZS, Weinreb RN et al (2017) A comparison of the diagnostic ability of vessel density and structural measurements of optical coherence tomography in primary open angle glaucoma. PLoS One 12:e0173930. https://doi.org/10.1371/journal.pone.0173930 CrossRefPubMedPubMedCentralGoogle Scholar
- 7.Shoji T, Zangwill LM, Akagi T, et al (2017) Progressive macula vessel density loss in primary open angle glaucoma: a longitudinal study. Am J Ophthalmol. doi: 710.1016/j.ajo.2017.07.011Google Scholar
- 18.Wang X, Jiang C, Ko T et al (2015) Correlation between optic disc perfusion and glaucomatous severity in patients with open-angle glaucoma: an optical coherence tomography angiography study. Graefes Arch Clin Exp Ophthalmol Albrecht Von Graefes Arch Klin Exp Ophthalmol 253:1557–1564. https://doi.org/10.1007/s00417-015-3095-y CrossRefGoogle Scholar
- 20.Lommatzsch C, Koch JM, Claußnitzer H, Heinz C (2017) OCT angiography of the glaucoma optic nerve. Klin Monatsbl Augenheilkd. doi: https://doi.org/10.1055/s-0042-123830
- 28.Akil H, Chopra V, Al-Sheikh M, et al (2017) Swept-source OCT angiography imaging of the macular capillary network in glaucoma. Br J Ophthalmol doi: https://doi.org/10.1136/bjophthalmol-2016-309816
- 33.Iafe NA, Phasukkijwatana N, Chen X, Sarraf D (2016) Retinal capillary density and foveal avascular zone area are age-dependent: quantitative analysis using optical coherence tomography angiography. Invest Ophthalmol Vis Sci 57:5780–5787. https://doi.org/10.1167/iovs.16-20045 CrossRefPubMedGoogle Scholar
- 34.Coscas F, Sellam A, Glacet-Bernard A et al (2016) Normative data for vascular density in superficial and deep capillary plexuses of healthy adults assessed by optical coherence tomography angiography. Invest Ophthalmol Vis Sci 57:OCT211–OCT223. https://doi.org/10.1167/iovs.15-18793 CrossRefPubMedGoogle Scholar
- 39.Vandewalle E, Abegão Pinto L, Olafsdottir OB, Stalmans I (2013) Phenylephrine 5% added to tropicamide 0.5% eye drops does not influence retinal oxygen saturation values or retinal vessel diameter in glaucoma patients. Acta Ophthalmol 91:733–737. https://doi.org/10.1111/j.1755-3768.2012.02545.x CrossRefPubMedGoogle Scholar