June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Perfused Large Vessel and Capillary Densities in Various Grades of Papilledema Using OCTA Custom Software
Author Affiliations & Notes
  • David Fell
    Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York, United States
    Medicine, Stony Brook University School of Medicine, Stony Brook, New York, United States
  • Sherief Raouf
    Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York, United States
    Medicine, Stony Brook University School of Medicine, Stony Brook, New York, United States
  • Toco Yuen Ping Chui
    Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York, United States
    Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York, United States
  • Patricia M. Garcia
    Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York, United States
  • Shelley Mo
    Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York, United States
    Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, United States
  • Sarita B Dave
    Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York, United States
  • Nicole K Scripsema
    Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York, United States
    Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York, United States
  • Richard B Rosen
    Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York, United States
    Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York, United States
  • Rudrani Banik
    Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York, United States
    Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York, United States
  • Footnotes
    Commercial Relationships   David Fell, None; Sherief Raouf, None; Toco Chui, None; Patricia Garcia, None; Shelley Mo, None; Sarita Dave, None; Nicole Scripsema, None; Richard Rosen, Optovue (C); Rudrani Banik, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 3305. doi:
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    • Get Citation

      David Fell, Sherief Raouf, Toco Yuen Ping Chui, Patricia M. Garcia, Shelley Mo, Sarita B Dave, Nicole K Scripsema, Richard B Rosen, Rudrani Banik; Perfused Large Vessel and Capillary Densities in Various Grades of Papilledema Using OCTA Custom Software. Invest. Ophthalmol. Vis. Sci. 2017;58(8):3305.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Optical Coherence Tomography Angiography (OCTA) AngioanalyticsTM software has limitations in papilledema including: inaccurate autosegmentation, difficulty identifying the scleral canal border and inability to separate large vessels (LV) from capillaries. The purpose of this study was to apply customized software to overcome these issues and analyze perfused vessel density in various grades of papilledema.

Methods : We performed a prospective cross-sectional analysis of eyes with papilledema using the RTVue XR AvantiTM OCTA. Images of choroid, radial peripapillary capillary (RPC), nerve head (NH), and vitreous layers were exported to MATLAB®. The choroid image was used to center a 1.95-millimeter annular ring on the scleral canal opening, and a surrounding 0.75-millimeter peripapillary ring was analyzed. Custom digital subtraction analysis software separated LVs from capillaries and calculated mean perfused LV density (PLVD) and perfused capillary density (PCD) in RPC, NH, and vitreous layers. ANOVAs comparing the results of each layer by papilledema grade were performed, with post-hoc Tukey’s procedure (PHTP) to examine individual relationships.

Results : One eye from each of 56 subjects with papilledema, Frisén grades 0-5 and atrophic papilledema (n = 7, 14, 15, 4, 5, 2, and 9, respectively), was analyzed. ANOVA with LV subtraction analysis revealed significant changes in PCD throughout all three layers (P≤0.04). PHTP showed patterns of decreased PCD in high grade and atrophic papilledema compared to low grade. ANOVA of LV analysis showed significant changes in PLVD within the NH (P=.01) and vitreous (P=0.002) layers. PHTP showed decreased PLVD in high grades within the NH layer and increased PLVD in atrophic subjects within the vitreous layer, when compared to low grade papilledema.

Conclusions : Customized OCTA post-processing software demonstrated significantly decreased PCD across high-grade papilledema and post-papilledema optic atrophy. LV analysis of NH and vitreous layers may reflect changes in LV visibility secondary to changes in peripapillary retinal nerve fiber layer thickness.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

 

NH Layer - (Left to right) Original OCTA image, OCTA image with vessel separation, and isolated peripapillary ring in low grade (0) and high grade (4) papilledema.

NH Layer - (Left to right) Original OCTA image, OCTA image with vessel separation, and isolated peripapillary ring in low grade (0) and high grade (4) papilledema.

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