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Ping Wei, Julie Falardeau, Jie Wang, Liang Liu, Ou Tan, Yali Jia, David Huang; OCT and OCT Angiography in Optic Neuropathies. Invest. Ophthalmol. Vis. Sci. 2021;62(8):2481.
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© ARVO (1962-2015); The Authors (2016-present)
To assess OCT and OCT angiography (OCTA) features in optic neuropathic diseases.
OCTA macular 6x6-mm and peripapillary 4.5x4.5-mm scans were obtained from the diseased eye of each patient and one eye of each normal participant, which included both structural and angiographic images. The flow signal was calculated using the split-spectrum amplitude-decorrelation angiography algorithm. The capillary density (CD) of peripapillary nerve fiber layer plexus (ppNFLP), vessel density (VD) of macular ganglion cell layer plexus (mGCLP) and macular superficial vascular complex (mSVC) were analyzed using a custom software with shadow removal, reflectance compensation and projection-resolved algorithms. The thickness of the peripapillary retinal nerve fiber layer (ppRNFL) and macular ganglion cell complex (mGCC), ganglion cell-inner plexiform layer (mGCIPL) was measured on structural OCT images.
Nine patients (13 eyes) with optic neuropathy, including 8 eyes/6 patients with nonarteritic anterior ischemic optic neuropathy, 1 eye with posterior ischemic optic neuropathy, and 4 eyes/2 patients with pituitary tumor, and 31 age-matched normal participants were included. The ppNFLP CD, mGCLP VD, mSVC VD, and thickness of ppRNFL, mGCC, and mGCIPL were all significantly reduced in eyes with optic neuropathies (Table 1). The OCTA diagnostic accuracy of optic neuropathic disease, measured by the area under the receiver operating curve (AROC), was 0.921 for ppNFLP CD, 0.868 for mGCLP VD, 0.841 for mSVC VD (sensitivity at 95% specificity was 84.6%, 69.2%, and 53.8%, respectively). For structural OCT parameters, the AROC was 0.809, 0.921, and 0.834 for ppRNFL, mGCIPL, and mGCC thickness, respectively (sensitivity at 95% specificity was 61.5%, 92.3%, and 61.5%, respectively). The patterns of loss on OCT and OCTA maps correlated well with visual field (VF) (Figure 1). The ppNFLP CD had the best correlation with VF mean deviation, then the thickness of ppRNFL, mGCIPL, mGCC, and the VD of mSVC, and mGCLP (Pearson’s r = 0.793, 0.737, 0.721, 0.689, 0.626, 0.589, respectively, all P<0.001).
OCT and OCTA provide detailed visualization of the peripapillary and macular retinal changes, which correlate well with visual field loss. The patterns of loss could be useful for the diagnosis and classification of optic neuropathies, while the quantification of thickness and perfusion parameters could be useful for assessing disease severity and progression.
This is a 2021 ARVO Annual Meeting abstract.
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