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Joao Barbosa-Breda, Danilo Andrade de Jesus, Karel Van Keer, Vahid Nassiri, Geert Molenberghs, Luís Abegão Pinto, Amandio A Rocha-Sousa, Evelien Vandewalle, Ingeborg Stalmans; AngioOCT peripapillary microvascular density outperforms standard OCT parameters as a discriminant between different glaucoma severity levels – The Leuven Eye Study. Invest. Ophthalmol. Vis. Sci. 2018;59(9):4478.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the ability of different optical coherence tomography (OCT) parameters to discriminate between different levels of glaucoma severity.
Data were retrieved from 144 patients included in the Leuven Eye Study (45 healthy controls, 99 glaucoma patients). OCT angiography (angioOCT) was performed in all patients with the Cirrus 5000 HD OCT® (Angioplex®, Carl Zeiss, Dublin, USA; 10.0 software version) and 3x3mm optic disc centered scans were acquired. Images were analysed with an in-house Matlab based tool, that enabled us to collect circumpapillary microvascular density (cpmVD) values, while correcting for the fovea-disc axis and avoiding the influence of the major retinal vessels (Figure 1). Mean retinal nerve fiber layer thickness (RNFL) and mean ganglion cell complex thickness (GCC) were also assessed.Standard automatic perimetry was performed in all glaucoma patients and mean deviation (dB) was used to classify the patients according to severity level. Group comparison was performed with the Kruskal Wallis test with Holm-bonferroni correction for pairwise comparison.
All three parameters showed a significant attenuation with increasing levels of severity (P < 0.001 for all groups). However, when performing a pairwise analysis, only the cpmVD was able to discriminate each severity level, while the RNFL and GCC were not able to distinguish between moderate and severe glaucoma (Table 1).
Circumpapillary microvascular density, measured with angioOCT, was the best discriminant between different glaucoma severity levels, when compared to commonly used structural OCT parameters. This serves to show the potential of angioOCT in everyday glaucoma management, especially in the follow-up of more advanced disease stages, where conventional OCT parameters face challenges due to a floor effect at earlier disease stages.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
Figure 1. Schematic representation of the in-house Matlab based tool for peripapillary angio-OCT analytics (A) – Rotation correction for fovea-disc axis; (B) – Optic disc image with a superimposed circumpapillary ring; (C) – Data collected from the ring displayed in (B); (D) – Plot of the circumpapillary microvascular density; (E) – Sectorial analysis
Table 1. Only cpmVD is able to discriminate between all glaucoma severity levels
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