Zaid Mammo1, Morgan Heisler2, Chandrakumar Balaratnasingam3, Sieun Lee2, Dao-Yi Yu4, Paul Mackenzie5, Steven Schendel1, Andrew Merkur1, Andrew Kirker1, David Albiani1, Eduardo Navajas1, Mirza Faisal Beg2, William Morgan4, Marinko V Sarunic6. 1. Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, British Columbia, Canada. 2. School of Engineering Science, Simon Fraser University, Burnaby, British Columbia, Canada. 3. Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, British Columbia, Canada; Vitreous Retina Macula Consultants of New York, New York, New York; LuEsther T. Mertz Retinal Research Center, Eye, Ear and Throat Hospital, New York, New York; Department of Physiology and Pharmacology, Centre for Ophthalmology and Visual Science, Lions Eye Institute, The University of Western Australia, Nedlands, Western Australia, Australia. 4. Department of Physiology and Pharmacology, Centre for Ophthalmology and Visual Science, Lions Eye Institute, The University of Western Australia, Nedlands, Western Australia, Australia. 5. Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, British Columbia, Canada; School of Engineering Science, Simon Fraser University, Burnaby, British Columbia, Canada. 6. School of Engineering Science, Simon Fraser University, Burnaby, British Columbia, Canada. Electronic address: msarunic@sfu.ca.
Abstract
PURPOSE: To evaluate the quantitative characteristics of the radial peripapillary capillary (RPC) network in glaucoma, glaucoma suspect, and normal eyes using speckle variance optical coherence tomography angiography (OCT-A). To determine correlations between RPC density, nerve fiber layer (NFL) thickness, and visual field indices. DESIGN: Cross-sectional study. METHODS: OCT-A images of RPCs were acquired at a single institution using a custom-built 1060 nm system from 3 groups: unilateral glaucoma (10 eyes from 5 subjects), glaucoma suspects (6 eyes from 3 subjects), and normal control eyes (16 eyes from 9 normal subjects). Peripapillary NFL thickness measurements were determined using spectral-domain optical coherence tomography. Glaucoma and glaucoma suspects also underwent automated 30-2 Humphrey visual field analysis. Manual tracing techniques were used to quantify RPC density in the OCT-A images. Data were analyzed using a linear mixed model with 1 fixed-effect covariate. Correlations between main outcome measures (RPC density, NFL thickness, and visual field index) were determined. RESULTS: Mean age was not significantly different between the 3 groups (P = .25). The density of RPCs was significantly lower in glaucomatous eyes compared with matched-peripapillary regions in the fellow eye, glaucoma suspect group, and normal group (all P < .001). RPC density was strongly correlated with NFL thickness (P < .001) and visual field index (P < .001). CONCLUSIONS: Significant reductions in RPC density were correlated with sites of NFL decrease and visual field loss in glaucoma. Speckle variance OCT-A allows visualization and quantification of RPCs and may therefore be a useful tool for indirectly quantifying and monitoring retinal ganglion cell axonal injury in glaucoma.
PURPOSE: To evaluate the quantitative characteristics of the radial peripapillary capillary (RPC) network in glaucoma, glaucoma suspect, and normal eyes using speckle variance optical coherence tomography angiography (OCT-A). To determine correlations between RPC density, nerve fiber layer (NFL) thickness, and visual field indices. DESIGN: Cross-sectional study. METHODS:OCT-A images of RPCs were acquired at a single institution using a custom-built 1060 nm system from 3 groups: unilateral glaucoma (10 eyes from 5 subjects), glaucoma suspects (6 eyes from 3 subjects), and normal control eyes (16 eyes from 9 normal subjects). Peripapillary NFL thickness measurements were determined using spectral-domain optical coherence tomography. Glaucoma and glaucoma suspects also underwent automated 30-2 Humphrey visual field analysis. Manual tracing techniques were used to quantify RPC density in the OCT-A images. Data were analyzed using a linear mixed model with 1 fixed-effect covariate. Correlations between main outcome measures (RPC density, NFL thickness, and visual field index) were determined. RESULTS: Mean age was not significantly different between the 3 groups (P = .25). The density of RPCs was significantly lower in glaucomatous eyes compared with matched-peripapillary regions in the fellow eye, glaucoma suspect group, and normal group (all P < .001). RPC density was strongly correlated with NFL thickness (P < .001) and visual field index (P < .001). CONCLUSIONS: Significant reductions in RPC density were correlated with sites of NFL decrease and visual field loss in glaucoma. Speckle variance OCT-A allows visualization and quantification of RPCs and may therefore be a useful tool for indirectly quantifying and monitoring retinal ganglion cell axonal injury in glaucoma.
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