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Yali Jia, Jie Wang, Liang Liu, John C Morrison, David Huang; Optical coherence tomography angiography of low radial peripapillary capillary density area in glaucoma. Invest. Ophthalmol. Vis. Sci. 2017;58(8):717.
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© ARVO (1962-2015); The Authors (2016-present)
To detect low capillary density area in the radial peripapillary capillary (RPC) plexus in primary open angle glaucoma (POAG) patients using optical coherence tomography angiography (OCTA).
One eye of each subject was scanned using the AngioVue 4.5-mm OCTA scan centered on the disc. En face RPC plexus (corresponding to the anatomic nerve fiber layer) angiogram was generated. The disc area (2mm diameter) and large vessels were identified by automated software and excluded from analysis. A binary capillary map is generated with a reflectance-adjusted threshold, and then low-pass filtered to obtain the capillary density, the fraction of area occupied by capillary pixels. To identify areas of low RPCP density, the threshold was set at 2.57 standard deviations below the reference mean at that location (0.5 percentile for normal distribution) derived from 40 healthy eyes.
Ten POAG and 10 healthy subjects (different from the 40 healthy subjects in the reference group) were analyzed. Focal capillary loss could be visualized in the RPC density map and on the map of low capillary density area (Fig. 1). The area of low RPC density (Fig. 2) in POAG eyes (3.46±1.74 mm2; mean±standard deviation) was higher than the healthy eyes (0.01±0.03 mm2, p<0.001, Mann-Whitney U Test), and highly correlated with visual field mean deviation (Pearson R = -0.88, p=0.001).Conclusions: The area of low RPC density is a novel OCTA parameter that identifies focal glaucoma damage with high diagnostic accuracy.
The area of low RPC density is a novel OCTA parameter that identifies focal glaucoma damage with high diagnostic accuracy.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
Mapping of capillary density in the radial peripapillary capillary plexus is demonstrated on 4.5mm OCTA scans of a normal eye and a glaucomatous eye. The glaucomatous eye has lower capillary density in general and shows an bi-arcuate pattern of focal loss on the map of low capillary density area (red area in panel F).
Comparison of low radial peripapillary capillary (RPC) density area in normal and glaucomatous eyes.
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