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Haksu Kyung, Elham Ghahari, Sasan Moghimi, Huiyuan Hou, Rafaella Penteado, Patricia Manalastas, Christopher Bowd, Linda M Zangwill, Robert N Weinreb, James Proudfoot; OCTA-measured vessel density and RNFL thickness in glaucomatous eyes with and without optic disc hemorrhage. Invest. Ophthalmol. Vis. Sci. 2019;60(9):5522.
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To determine whether OCT-A-measured vessel density or OCT-measured RNFL thickness differs between glaucomatous eyes with and without optic disc hemorrhages visible on stereoscopic optic disc photographs and to determine whether these parameters can successfully differentiate between these groups.
Stereoscopic optic disc photographs from 223 stereoscopic glaucoma patients were divided into 2 groups. 192 eyes with observable optic disc hemorrhages (DH group) and 31 eyes without optic disc hemorrhages (noDH group). OCTA-measured vessel density and OCT-measured RNFL thickness (OptoVueAvanti with AngioVue software) measurements were evaluated. Mann-Whitney U test for vessel density and tissue thickness parameters between groups, ROC analyses for the ability of these measurements. AUROCs were compared between measures using DeLong’s test. Optic nerve head (ONH) and macular area were also investigated.
Median OCT-A thickness and vessel density parameters in the IT sector were significantly lower in DH patients. The AUROC of OCT-A thickness parameters in the IT sector were similar (AUROC (95% CI, p-value): IT thickness 0.656 (0.569, 0.743, p = 0.005), Garway-Heath (GH) IT thickness 0.652 (0.569, 0.736, p = 0.007), TSNIT IT thickness 0.654 (0.569, 0.739, p = 0.006)), as were the AUROCs of OCT-A vessel density parameters in the IT sector (AUROC (95% CI, p-value): GH-IT radial peripapillary capillaries (RPC) 0.684 (0.608, 0.760, p = 0.001), TSNIT-IT RPC 0.666 (0.581, 0.752, p = 0.003)). The AUROC of GH-IT RPC was higher than OCT-A IT sector thickness parameters, but not significantly different (all p > 0.363).In OCT-A macula, median full ganglion cell complex volume in the inferior hemisphere was lower in the DH group (median: 0.127 mm3 in DH, 0.150 mm3 in no DH, p = 0.050). Superficial macular vessel densitymeasurements were similar between groups, but deep macular whole image vessel density and parafovea vessel density appeared higher in the no DH group with borderline significance (p = 0.064 and p = 0.087, respectively).
In ONH OCT-A,vessel density of GH-IT RPC showed the best ability to distinguish between DH and non-DH glaucoma patients, though the AUROC was not statistically significantly different from RNFL thickness. Deep layer OCT-A macular vessel density may also be a tool to identify DH glaucoma patients.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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