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Carolyn Majcher, Rick Trevino, Kirsti Ramirez, William Eric Sponsel, Elizabeth Dosch, Jobeth Nozicka, Carissa Villaflor; Evaluation of OCT Angiography Nerve and Peripapillary Vasculature and Vasculature-Structure, Vasculature-Function Relationships in Glaucoma. Invest. Ophthalmol. Vis. Sci. 2018;59(9):5056.
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© ARVO (1962-2015); The Authors (2016-present)
To quantify OCTA nerve and peripapillary changes in glaucoma and investigate relationships between OCTA and other clinical tests.
Subjects were nondiabetic and one eye was analyzed. Glaucoma eyes (GEs) had defects on 2 reliable VFs with cupping and/or NFL loss. Controls had normal exam. Subjects had 6mm and 3mm ONH OCTA (NIDEK AngioScan®), ONH/macula OCT, VF (Humphrey HFAII®), pERG, and VEP (Diopsys®) done. Average (%VDa) and quadrant (%VDi, %VDs, %VDn, %VDt) % capillary vessel densities were calculated from local threshold OCTA radial peripapillary capillary 3mm (3rpc) and 6mm (6rpc) scans. VD of the ONH using the lamina cribrosa preset (%VDlc) was analyzed. Unpaired unequal variance 2-tailed ttests were used. Pearson correlations were done for VD and VF MD and PSD, average NFL and ganglion cell complex (GCC), VEP p100 high and low contrast (Hc, Lc) amplitude and latency, and ERG Hc and Lc magnitudeD/magnitude (magD/mag).
15 control eyes (CEs) and 11 GEs were evaluated. Mean (± SD) age was CE: 49±9 yrs and GE: 59±13 (p=.06). Among GEs there were 4 mild, 4 moderate, and 3 severe, as well as 7 OAG, 2 ACG, and 2 mixed. OCTA %VDa and %VDi for 3rpc (57.7±2.2 vs 51.7±7.8% p=.04, 57.8±3.7 vs 44.2±13.7% p=.01) and 6rpc (51.4±2.9 vs 45.5±7.0% p=.05, 54.1±3.7 vs 44.9±10.9% p=.04) were lower in GEs. %VDlc was also reduced (44.3±8.0 vs 34.1±11.5% p=.03). 3rpc %VDi had the largest ROC AUC of 0.78 (53.6% cutoff= 73% sensitivity, 87% specificity). In glaucoma eyes VF MD was correlated with various 3rpc and 6rpc measures, especially 3rpc %VDn (r=.88, p=.0004). VEP Hc latency negatively correlated with both 3rpc and 6rpc %VDs (r=-.74, p=.02; r=-.72, p=.04).There was no correlation between 6rpc VD and pERG. %VDlc correlated with pERG Hc magD/mag (r=.72, p=.03); 3rpc %VDa and %VDn were correlated with both Hc and Lc magD/mag. All 3rpc measures, especially %VDa (r=.94, p=.00007) correlated with GCC as well as %VDlc (r=.77, p=.009). NFL correlated with all VD measures particularly 6rpc %VDa (r=.97, p=.00002).
Our results suggest that nerve and peripapillary %VD, particularly inferior, is lower in glaucoma. VF MD appears to relate more to 3rpc than 6rpc or lc VD. 3rpc VD and lc VD correspond with ganglion cell structure/function tests (GCC/pERG), while both 3rpc and 6rpc correlate with NFL. VEP Hc latency appears to correlate with superior VD.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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