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Ophthalmology. 2014 Jul;121(7):1322-32. doi: 10.1016/j.ophtha.2014.01.021. Epub 2014 Mar 12.

Optical coherence tomography angiography of optic disc perfusion in glaucoma.

Author information

1
Casey Eye Institute, Oregon Health & Science University, Portland, Oregon.
2
Pattern Recognition Lab and School of Advanced Optical Technologies, University Erlangen-Nuremberg, Erlangen, Germany; Department of Electrical Engineering and Computer Science, and Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, Massachusetts.
3
Department of Electrical Engineering and Computer Science, and Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, Massachusetts.
4
Casey Eye Institute, Oregon Health & Science University, Portland, Oregon. Electronic address: davidhuang@alum.mit.edu.

Abstract

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.

PMID:
24629312
PMCID:
PMC4082728
DOI:
10.1016/j.ophtha.2014.01.021
[Indexed for MEDLINE]
Free PMC Article

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