Purchase this article with an account.
Natalia Ivanovna Kurysheva, Ekaterina Vladimirovna Maslova, Inna Vladimirovna Zolnikova, Alexey Valentinovich Fomin; Role of OCT-angiography and electrophysiological testing in glaucoma diagnostics and monitoring. Invest. Ophthalmol. Vis. Sci. 2018;59(9):5050.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
For several decades, there has been a debate on which parameters – structural or functional – are of the highest diagnostic value in glaucoma. Our purpose was to compare the diagnostic accuracy of structural parameters measured by optical coherence tomography (OCT), vessel density measured by OCT-angiography, and electrophysiological testing in diagnosis of primary open-angle glaucoma (POAG).
35 healthy participants and 90 POAG patients underwent the measurement of whole en face image vessel density in disc/peripapillary region and macula, retinal nerve fiber layer and ganglion cell complex thickness, pattern electroretinogram and pattern visual evoked potential. The area under receiver operating characteristic curve (AUC) was assessed for each parameter in differentiating early POAG from the healthy eyes and from other POAG stages.
For distinguishing early POAG from the healthy eyes, the parameters with the highest AUC were detected: P50 amplitude of pattern electroretinogram, 1° (AUC 0.95, p < 0.0001), P1 component of steady-state pattern electroretinogram (AUC 0.92, p < 0.0001), P100 amplitude of pattern visual evoked potential, 1° (AUC 0.84, p < 0.0001), wiVD macula superficial (AUC 0.81, p < 0.0001), wiVD disc (AUC 0.76, p = 0.001), avg.GCC (AUC 0.74, p = 0.002) and for distinguishing early POAG from the moderate to severe POAG: inferotemporal peripapillary vessel density (AUC 0.98, p < 0.0001), avg.GCC (AUC 0.89, p < 0.0001) and P100 amplitude of pattern visual evoked potential (AUC 0.71, p = 0.009).
Our results demonstrate the importance of measuring the microcirculation parameters in the macular area along with pattern electroretinogram, and pattern visual evoked potential for the early diagnosis of glaucoma and the vessel density in the inferotemporal sector of peripapillary retina and pattern visual evoked potential – for monitoring of the disease. The combination of OCT-angiography and electrophysiological testing is promising in glaucoma diagnostics.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
Figure: Clinical examples of the normal controls (A1-E1), early glaucoma (B2-E2), and severe glaucoma (A3-E3). Ganglion cell complex map and retinal nerve fiber layer thickness map (A1-E3), Standard automated perimetry visual field results showing corresponding visual field defects (C1-C3), PVEP-protocols (D1-D3), PERG-protocols (E1-E3).
This PDF is available to Subscribers Only