Abstract
Purpose :
To compare the diagnostic accuracy of OCTA parameters and circumpapillary retinal nerve fibre layer thickness (cRNFLT) for perimetric glaucoma.
Methods :
Northern Ireland Cohort for the Longitudinal Study of Ageing participants with vertical cup to disc ratio ≥0.7 and/or intraocular pressure ≥25mmHg were invited to clinical examination by a glaucoma expert and full-threshold 24-2 perimetry. Eyes were diagnosed as “glaucoma”, “glaucoma suspect” or “control”. Participants underwent OCTA and SD-OCT scans with Heidelberg Spectralis OCT2 at the same visit. OCTA en face images were segmented using ImageJ and quantitatively analysed using AngioTool. Areas under the receiver operating characteristic (AUROC) curves were calculated for diagnostic parameters using funcs_clusteredROC.R. Comparisons of AUROC curves were made between the mean global OCTA parameters and mean global cRNFLT.
Results :
63 eyes from 46 participants (mean age [SD] 65.33 [7.39]; 43.48% female) were included. Circumpapillary vasuclar flow density (cVFD) was statistically significantly lower in glaucoma eyes (n=20; 23.77%) compared to control eyes (n=16; 26.14%; p<0.05) and glaucoma suspect eyes (n=27; 25.65%; p<0.05). OCTA total number of vessel junctions was statistically significantly lower in glaucoma eyes (165.10) compared to control eyes (210.18; p<0.05) and glaucoma suspect eyes (207.07; p<0.05). OCTA mean lacunarity was statistically significantly higher in glaucoma eyes (0.705) compared to control eyes (0.666; p<0.05) and glaucoma suspect eyes (0.670; p<0.05). Mean global cRNFLT was statistically significantly lower in glaucoma eyes (70.05 µm) compared to control eyes (92.19 µm; p<0.05) and glaucoma suspect eyes (88.63 µm; p<0.05). AUROC (SE) was 0.83 (0.07) for OCTA cVFD, compared to 0.82 (0.06) for OCTA total number of vessel junctions (p=0.80), and 0.81 (0.07) for OCTA mean lacunarity (p=0.76). AUROC was 0.85 (0.06) for cRNFLT compared to 0.83 (0.07) for cVFD (p=0.74).
Conclusions :
In participants referred from a population-based cohort study, OCTA mean global cVFD was the best performing OCTA parameter. Mean global cRNFLT was the overall best performing diagnostic parameter, however, it was not statistically significantly different from OCTA mean global cVFD. Longitudinal studies are required to assess the role of OCTA in detecting glaucoma progression.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.