August 2019
Volume 60, Issue 11
Free
ARVO Imaging in the Eye Conference Abstract  |   August 2019
Preferred OCTA Scanning Protocol for Glaucoma Discrimination
Author Affiliations & Notes
  • Ravneet Singh Rai
    NYU Eye Center, NYU Langone Health, New York, New York, United States
  • Katie Lucy
    NYU Eye Center, NYU Langone Health, New York, New York, United States
  • Nathaniel Tracer
    NYU Eye Center, NYU Langone Health, New York, New York, United States
  • Mengfei Wu
    NYU Eye Center, NYU Langone Health, New York, New York, United States
  • Maria de los Angeles Ramos Cadena
    NYU Eye Center, NYU Langone Health, New York, New York, United States
  • Aushim Kokroo
    NYU Eye Center, NYU Langone Health, New York, New York, United States
  • Siddarth Rathi
    NYU Eye Center, NYU Langone Health, New York, New York, United States
  • Assumpta Madu
    NYU Eye Center, NYU Langone Health, New York, New York, United States
  • Jesus Jiménez-Román
    Glaucoma, Asociación Para Evitar la Ceguera en México I.A.P., Mexico City, CDMX, Mexico
  • Gabriel Lazcano-Gómez
    Glaucoma, Asociación Para Evitar la Ceguera en México I.A.P., Mexico City, CDMX, Mexico
  • Joong Wong Shin
    Gangneung Asan Hospital, University of Ulsan, Gangneung, Gangneung, Korea (the Republic of)
    Ophthalmology, College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea (the Republic of)
  • Sung Kyung Rim
    Ophthalmology, College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea (the Republic of)
  • Hiroshi Ishikawa
    NYU Eye Center, NYU Langone Health, New York, New York, United States
  • Joel S Schuman
    NYU Eye Center, NYU Langone Health, New York, New York, United States
  • Gadi Wollstein
    NYU Eye Center, NYU Langone Health, New York, New York, United States
  • Footnotes
    Commercial Relationships   Ravneet Rai, None; Katie Lucy, None; Nathaniel Tracer, None; Mengfei Wu, None; Maria de los Angeles Ramos Cadena, None; Aushim Kokroo, None; Siddarth Rathi, None; Assumpta Madu, None; Jesus Jiménez-Román, None; Gabriel Lazcano-Gómez, None; Joong Wong Shin, None; Sung Kyung Rim, None; Hiroshi Ishikawa, None; Joel Schuman, Zeiss (P); Gadi Wollstein, None
  • Footnotes
    Support  NIH: R01-EY013178
Investigative Ophthalmology & Visual Science August 2019, Vol.60, PB051. doi:https://doi.org/
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      Ravneet Singh Rai, Katie Lucy, Nathaniel Tracer, Mengfei Wu, Maria de los Angeles Ramos Cadena, Aushim Kokroo, Siddarth Rathi, Assumpta Madu, Jesus Jiménez-Román, Gabriel Lazcano-Gómez, Joong Wong Shin, Sung Kyung Rim, Hiroshi Ishikawa, Joel S Schuman, Gadi Wollstein; Preferred OCTA Scanning Protocol for Glaucoma Discrimination. Invest. Ophthalmol. Vis. Sci. 2019;60(11):PB051. doi: https://doi.org/.

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

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Abstract

Purpose : OCT Angiography (OCTA) can be used to measure retinal vessel density (VD). These scans can be of various sizes and may be centered on the optic nerve head (ONH) or macula. In this study, we examined the glaucoma discrimination performance of VD using different scanning sizes and locations and compared it with the performance of conventional structural and functional biomarkers to identify the best glaucoma discrimination scanning protocol.

Methods : 79 healthy and glaucomatous eyes (50 subjects) were included in the study. Subjects with diabetes, vascular disease, or who were using medications known to affect retinal thickness were excluded. 3x3 and 6x6mm ONH and macula OCTA images were obtained using Cirrus HD-OCT Angioplex (Zeiss, Dublin, CA). Global and sectoral VD was calculated using native software on the device. Area under the receiver operating characteristics (AUC) was used to determine the discrimination ability of VD, retinal nerve fiber layer (RNFL) thickness, rim area, cup-to-disc (C/D) ratio, ganglion cell inner plexiform layer (GCIPL) thickness, and visual field mean deviation (MD). Bootstrapping was used for comparison between the AUCs.

Results : Subjects with glaucoma had statistically significantly different measurements than healthy individuals for all tested parameters except for the majority of macula VD (both 3x3 and 6x6 scanning sizes; Table). VD measurements that had the best glaucoma discrimination ability were acquired from the ONH from all sectors of the 3x3 scans and in the outer and full sectors in the 6x6 scans (Table). For these ONH parameters, no significant difference was detected from the best discriminating parameter (average RNFL and rim area). All macula VD measurements had significantly worse discrimination performance.

Conclusions : Among VD scanning options, the ONH scans are the most suitable for glaucoma discrimination. However, the coarse sampling in the larger scan (6x6mm) reduces this capability inside and immediately adjacent to the ONH.

This abstract was presented at the 2019 ARVO Imaging in the Eye Conference, held in Vancouver, Canada, April 26-27, 2019.

 

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