July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Comparison of the Diagnostic Accuracy of Macular Vessel Parameters from 4.5mmx4.5mm and 6mmx6mm SD-OCT Angiography Scans for Glaucoma
Author Affiliations & Notes
  • Yong Seok Han
    Ophthalmology, USC Roski Eye Institute, Los Angeles, California, United States
  • Ryuna Chang
    Ophthalmology, USC Roski Eye Institute, Los Angeles, California, United States
  • Zhongdi Chu
    University of Washington, Seattle, Washington, United States
  • Bruce Burkemper
    Ophthalmology, USC Roski Eye Institute, Los Angeles, California, United States
  • Sahar Bedrood
    Ophthalmology, USC Roski Eye Institute, Los Angeles, California, United States
  • Alena Reznik
    Ophthalmology, USC Roski Eye Institute, Los Angeles, California, United States
  • Ruikang K Wang
    Ophthalmology, USC Roski Eye Institute, Los Angeles, California, United States
  • Grace Richter
    Ophthalmology, USC Roski Eye Institute, Los Angeles, California, United States
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 5059. doi:
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      Yong Seok Han, Ryuna Chang, Zhongdi Chu, Bruce Burkemper, Sahar Bedrood, Alena Reznik, Ruikang K Wang, Grace Richter; Comparison of the Diagnostic Accuracy of Macular Vessel Parameters from 4.5mmx4.5mm and 6mmx6mm SD-OCT Angiography Scans for Glaucoma. Invest. Ophthalmol. Vis. Sci. 2018;59(9):5059.

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

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Abstract

Purpose : OCT Angiography (OCTA) of the macula may serve as a diagnostic tool for glaucoma. We compared the ability of macular vessel parameters from 4.5mmx4.5mm scans (“4.5”) and 6mmx6mm scans (“6.0”) to differentiate primary open angle glaucoma (POAG) from normal patients based on quantifications of the entire scan or of an elliptical region (horizontal axes 0.6mm and 2.4mm; vertical axes 0.5mm and 2.0mm) centered on the foveal avascular zone. We hypothesized that the global 6.0 scan parameters would have higher diagnostic accuracy due to inclusion of peripheral areas of the macula.

Methods : 4.5 and 6.0 scans were exported from prototype and commercial spectral domain OCTA, respectively, and processed using custom quantification software to create en face images of the superficial retinal layers on normal (30 eyes, 19 patients) and primary open angle glaucoma (53 eyes, 39 patients; pre-perimetric to severe) eyes. Vessel area density (VAD), vessel skeleton density (VSD), vessel complexity index (VCI), and flux were calculated for the global and elliptical areas (Figure). Area-under-curve (AUC) statistics, controlling for age and inter-eye correlation, were used to determine diagnostic accuracy.

Results : For the global quantification, the AUC for the 4.5 versus 6.0 scans for VAD was 0.67 (p=0.004) and 0.82 (p=<0.0001), respectively (AUC difference [Δ]: p=0.01); for VSD, 0.68 (p=0.002) versus 0.82 (p<0.0001), [Δ]:p=0.02; for VCI, 0.67 (p=0.0047) versus 0.81 (p<0.0001), [Δ]:p=0.02; for flux, 0.68 (p=0.0024) versus 0.85 (p<0.0001), [Δ]:p=0.01.
For the elliptical quantification, the AUC for 4.5 versus 6.0 scans for VAD was 0.65 (p=0.0188) and 0.73 (p=0.0001), respectively ([Δ]: p=0.19); for VSD, 0.67 (p=0.0043) versus 0.75 (p<0.0001), [Δ]:p=0.24; for VCI, 0.64 (p=0.0225) versus 0.72 (p=0.0002), [Δ]:p=0.24; for flux, 0.63 (p=0.0467) versus 0.73 (p=0.0003), [Δ]:p=0.15.

Conclusions : All global parameters for the 6.0 scans outperformed those of the 4.5 scans. For the elliptical quantifications, there was a similar trend towards statistical significance. While the 4.5 scans used slightly different prototype image processing methods, it is possible that improved resolution does not improve diagnostic accuracy.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

 

Figure. En face 4.5 scan of OS macula of a glaucoma patient (A) with elliptical quantification region (B). 6.0 scans of same eye (C, D).

Figure. En face 4.5 scan of OS macula of a glaucoma patient (A) with elliptical quantification region (B). 6.0 scans of same eye (C, D).

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