Optical Coherence Tomography Angiography of Optic Disc Perfusion in Glaucoma
Author(s)
Jia, Yali; Wei, Eric; Wang, Xiaogang; Zhang, Xinbo; Morrison, John C.; Parikh, Mansi; Lombardi, Lori H.; Gattey, Devin M.; Armour, Rebecca L.; Edmunds, Beth; Kraus, Martin F.; Fujimoto, James G.; Huang, David; ... Show more Show less
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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[superscript 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.
Date issued
2014-03Department
Massachusetts Institute of Technology. Department of Electrical Engineering and Computer Science; Massachusetts Institute of Technology. Research Laboratory of ElectronicsJournal
Ophthalmology
Publisher
Elsevier
Citation
Jia, Yali, Eric Wei, Xiaogang Wang, Xinbo Zhang, John C. Morrison, Mansi Parikh, Lori H. Lombardi, et al. “Optical Coherence Tomography Angiography of Optic Disc Perfusion in Glaucoma.” Ophthalmology 121, no. 7 (July 2014): 1322–1332.
Version: Author's final manuscript
ISSN
01616420