Masoud Aghsaei Fard1, Jalil Jalili2, Alireza Sahraiyan3, Hassan Khojasteh3, Marjane Hejazi2, Robert Ritch4, Prem S Subramanian5. 1. Farabi Eye Hospital BB, Eye Research Center, Tehran University of Medical Science, Tehran, Iran. Electronic address: masood219@gmail.com. 2. Medical Physics and Biomedical Engineering Department, Recearch Center for Molecular and Cellular Imaging, Bio-Optical Imaging Group, School of Medicine, Tehran University of Medical Science, Tehran, Iran. 3. Farabi Eye Hospital BB, Eye Research Center, Tehran University of Medical Science, Tehran, Iran. 4. Einhorn Clinical Research Center, New York Eye and Ear Infirmary of Mount Sinai, New York, New York, USA. 5. Department of Ophthalmology, University of Colorado, School of Medicine, Aurora, Colorado, USA.
Abstract
PURPOSE: To compare optical coherence tomography angiography (OCT-A) of peripapillary total vasculature and capillaries in patients with optic disc swelling. DESIGN: Cross-sectional study. METHODS: Twenty nine eyes with acute nonarteritic anterior ischemic optic neuropathy (NAION), 44 eyes with papilledema, 8 eyes with acute optic neuritis, and 48 eyes of normal subjects were imaged using OCT-A. Peripapillary total vasculature information was recorded using a commercial vessel density map. Customized image analysis with major vessel removal was also used to measure whole-image capillary density and peripapillary capillary density (PCD). RESULTS: Mixed models showed that the peripapillary total vasculature density values were significantly lower in NAION eyes, followed by papilledema eyes and control eyes, using commercial software (P < .0001 for all comparisons). The customized software also showed significantly lower PCD of NAION eyes compared with papilledema eyes (all P < .001), but did not show significant differences between papilledema and control subjects. Our software showed significantly lower whole image and PCD in eyes with optic neuritis than papilledema. There was no significant difference between NAION and optic neuritis using our software. The area under the receiver operating curves for discriminating NAION from papilledema eyes and optic neuritis from papilledema eyes was highest for whole-image capillary density (0.94 and 0.80, respectively) with our software, followed by peripapillary total vasculature (0.9 and 0.74, respectively) with commercial software. CONCLUSIONS: OCT-A is helpful to distinguish NAION and papillitis from papilledema. Whole-image capillary density had the greatest diagnostic accuracy for differentiating disc swelling.
PURPOSE: To compare optical coherence tomography angiography (OCT-A) of peripapillary total vasculature and capillaries in patients with optic disc swelling. DESIGN: Cross-sectional study. METHODS: Twenty nine eyes with acute nonarteritic anterior ischemic optic neuropathy (NAION), 44 eyes with papilledema, 8 eyes with acute optic neuritis, and 48 eyes of normal subjects were imaged using OCT-A. Peripapillary total vasculature information was recorded using a commercial vessel density map. Customized image analysis with major vessel removal was also used to measure whole-image capillary density and peripapillary capillary density (PCD). RESULTS: Mixed models showed that the peripapillary total vasculature density values were significantly lower in NAION eyes, followed by papilledema eyes and control eyes, using commercial software (P < .0001 for all comparisons). The customized software also showed significantly lower PCD of NAION eyes compared with papilledema eyes (all P < .001), but did not show significant differences between papilledema and control subjects. Our software showed significantly lower whole image and PCD in eyes with optic neuritis than papilledema. There was no significant difference between NAION and optic neuritis using our software. The area under the receiver operating curves for discriminating NAION from papilledema eyes and optic neuritis from papilledema eyes was highest for whole-image capillary density (0.94 and 0.80, respectively) with our software, followed by peripapillary total vasculature (0.9 and 0.74, respectively) with commercial software. CONCLUSIONS:OCT-A is helpful to distinguish NAION and papillitis from papilledema. Whole-image capillary density had the greatest diagnostic accuracy for differentiating disc swelling.