Quantitative optical coherence tomography angiography of macular vascular structure and foveal avascular zone in glaucoma

The study aimed to evaluate the quantitative characteristics of the macular vessel density (VD) and foveal avascular zone (FAZ) in glaucoma using optical coherence tomography angiography (OCT-A). Cross-sectional, age- and sex-matched case-control study. Fifty-two eyes of 52 patients with primary ope...

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Published inPloS one Vol. 12; no. 9; p. e0184948
Main Authors Choi, Jaewan, Kwon, Junki, Shin, Joong Won, Lee, Jiyun, Lee, Saem, Kook, Michael S
Format Journal Article
LanguageEnglish
Published United States Public Library of Science 21.09.2017
Public Library of Science (PLoS)
Subjects
Adjustment
Adult
Aged
Analysis
Angiography
Bioindicators
Biology and Life Sciences
Biomarkers
Case-Control Studies
Circularity
Coherence
Control methods
Cross-Sectional Studies
Diabetes
Diabetic retinopathy
Diagnostic systems
Disruption
Error analysis
Errors
Eye
Eye (anatomy)
Fluorescein Angiography
Fovea
Fovea Centralis - blood supply
Fovea Centralis - pathology
Glaucoma
Glaucoma, Open-Angle - physiopathology
Health aspects
Humans
Hypoxia
Macula Lutea - blood supply
Macula Lutea - pathology
Male
Medical imaging
Medicine
Medicine and Health Sciences
Middle Aged
Optical Coherence Tomography
Optical tomography
Optics
Patients
Physical Sciences
Physiological aspects
Regression analysis
Regression models
Research and Analysis Methods
Retina
Retrospective Studies
Sex
Sex ratio
Tomography
Tomography, Optical Coherence - methods
Veins & arteries
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Abstract The study aimed to evaluate the quantitative characteristics of the macular vessel density (VD) and foveal avascular zone (FAZ) in glaucoma using optical coherence tomography angiography (OCT-A). Cross-sectional, age- and sex-matched case-control study. Fifty-two eyes of 52 patients with primary open angle glaucoma and 52 eyes from 52 healthy participants were recruited retrospectively. OCT-A was performed on a 3 x 3-mm macular region centered on the fovea. OCT-A scans were manually graded to define the FAZ. Parafoveal VD in superficial and deep retina were analyzed in the circular- and quadrant-segmented zone. The FAZ parameters included size, perimeter, and circularity index. The regression analysis among VD and FAZ-related parameters and ocular parameters was performed, and the diagnostic ability was calculated with refractive error adjusted. For both groups, the mean age and the sex ratio was not different between groups. With refractive error adjusted, the average macular VD was lower in glaucoma than in the control group for superficial (P = 0.013), deep (P<0.001), and the whole retina (P = 0.002). There were increased FAZ perimeter and decreased FAZ circularity index in glaucoma when compared with controls (P<0.001). In the multivariate regression models, FAZ circularity index were significantly associated with decreased peripapillary RNFL thickness (P = 0.007) and macular GCIPL thickness (P = 0.009) measured by OCT. The refractive-error adjusted area under receiver operating characteristics was highest for FAZ circularity index (0.905; 95% CI, 0.844-0.966), followed by temporal deep retinal VD (0.870; 95% CI, 0.803-0.937) and FAZ perimeter (0.858; 95% CI, 0.784-0.932). Decreased macular VD, increased FAZ perimeter, and decreased FAZ circularity index were observed in eyes with glaucoma using OCT-A. With refractive error adjusted, these parameters showed considerable diagnostic value for glaucoma. FAZ circularity index may be a novel biomarker representing disruption of the parafoveal capillary network in glaucoma, as supported by its association with structural parameters.
AbstractList Objective The study aimed to evaluate the quantitative characteristics of the macular vessel density (VD) and foveal avascular zone (FAZ) in glaucoma using optical coherence tomography angiography (OCT-A). Design Cross-sectional, age- and sex-matched case-control study. Methods Fifty-two eyes of 52 patients with primary open angle glaucoma and 52 eyes from 52 healthy participants were recruited retrospectively. OCT-A was performed on a 3 x 3-mm macular region centered on the fovea. OCT-A scans were manually graded to define the FAZ. Parafoveal VD in superficial and deep retina were analyzed in the circular- and quadrant-segmented zone. The FAZ parameters included size, perimeter, and circularity index. The regression analysis among VD and FAZ-related parameters and ocular parameters was performed, and the diagnostic ability was calculated with refractive error adjusted. Results For both groups, the mean age and the sex ratio was not different between groups. With refractive error adjusted, the average macular VD was lower in glaucoma than in the control group for superficial (P = 0.013), deep (P<0.001), and the whole retina (P = 0.002). There were increased FAZ perimeter and decreased FAZ circularity index in glaucoma when compared with controls (P<0.001). In the multivariate regression models, FAZ circularity index were significantly associated with decreased peripapillary RNFL thickness (P = 0.007) and macular GCIPL thickness (P = 0.009) measured by OCT. The refractive-error adjusted area under receiver operating characteristics was highest for FAZ circularity index (0.905; 95% CI, 0.844-0.966), followed by temporal deep retinal VD (0.870; 95% CI, 0.803-0.937) and FAZ perimeter (0.858; 95% CI, 0.784-0.932). Conclusions Decreased macular VD, increased FAZ perimeter, and decreased FAZ circularity index were observed in eyes with glaucoma using OCT-A. With refractive error adjusted, these parameters showed considerable diagnostic value for glaucoma. FAZ circularity index may be a novel biomarker representing disruption of the parafoveal capillary network in glaucoma, as supported by its association with structural parameters.
The study aimed to evaluate the quantitative characteristics of the macular vessel density (VD) and foveal avascular zone (FAZ) in glaucoma using optical coherence tomography angiography (OCT-A). Cross-sectional, age- and sex-matched case-control study. Fifty-two eyes of 52 patients with primary open angle glaucoma and 52 eyes from 52 healthy participants were recruited retrospectively. OCT-A was performed on a 3 x 3-mm macular region centered on the fovea. OCT-A scans were manually graded to define the FAZ. Parafoveal VD in superficial and deep retina were analyzed in the circular- and quadrant-segmented zone. The FAZ parameters included size, perimeter, and circularity index. The regression analysis among VD and FAZ-related parameters and ocular parameters was performed, and the diagnostic ability was calculated with refractive error adjusted. For both groups, the mean age and the sex ratio was not different between groups. With refractive error adjusted, the average macular VD was lower in glaucoma than in the control group for superficial (P = 0.013), deep (P<0.001), and the whole retina (P = 0.002). There were increased FAZ perimeter and decreased FAZ circularity index in glaucoma when compared with controls (P<0.001). In the multivariate regression models, FAZ circularity index were significantly associated with decreased peripapillary RNFL thickness (P = 0.007) and macular GCIPL thickness (P = 0.009) measured by OCT. The refractive-error adjusted area under receiver operating characteristics was highest for FAZ circularity index (0.905; 95% CI, 0.844-0.966), followed by temporal deep retinal VD (0.870; 95% CI, 0.803-0.937) and FAZ perimeter (0.858; 95% CI, 0.784-0.932). Decreased macular VD, increased FAZ perimeter, and decreased FAZ circularity index were observed in eyes with glaucoma using OCT-A. With refractive error adjusted, these parameters showed considerable diagnostic value for glaucoma. FAZ circularity index may be a novel biomarker representing disruption of the parafoveal capillary network in glaucoma, as supported by its association with structural parameters.
OBJECTIVEThe study aimed to evaluate the quantitative characteristics of the macular vessel density (VD) and foveal avascular zone (FAZ) in glaucoma using optical coherence tomography angiography (OCT-A).DESIGNCross-sectional, age- and sex-matched case-control study.METHODSFifty-two eyes of 52 patients with primary open angle glaucoma and 52 eyes from 52 healthy participants were recruited retrospectively. OCT-A was performed on a 3 x 3-mm macular region centered on the fovea. OCT-A scans were manually graded to define the FAZ. Parafoveal VD in superficial and deep retina were analyzed in the circular- and quadrant-segmented zone. The FAZ parameters included size, perimeter, and circularity index. The regression analysis among VD and FAZ-related parameters and ocular parameters was performed, and the diagnostic ability was calculated with refractive error adjusted.RESULTSFor both groups, the mean age and the sex ratio was not different between groups. With refractive error adjusted, the average macular VD was lower in glaucoma than in the control group for superficial (P = 0.013), deep (P<0.001), and the whole retina (P = 0.002). There were increased FAZ perimeter and decreased FAZ circularity index in glaucoma when compared with controls (P<0.001). In the multivariate regression models, FAZ circularity index were significantly associated with decreased peripapillary RNFL thickness (P = 0.007) and macular GCIPL thickness (P = 0.009) measured by OCT. The refractive-error adjusted area under receiver operating characteristics was highest for FAZ circularity index (0.905; 95% CI, 0.844-0.966), followed by temporal deep retinal VD (0.870; 95% CI, 0.803-0.937) and FAZ perimeter (0.858; 95% CI, 0.784-0.932).CONCLUSIONSDecreased macular VD, increased FAZ perimeter, and decreased FAZ circularity index were observed in eyes with glaucoma using OCT-A. With refractive error adjusted, these parameters showed considerable diagnostic value for glaucoma. FAZ circularity index may be a novel biomarker representing disruption of the parafoveal capillary network in glaucoma, as supported by its association with structural parameters.
The study aimed to evaluate the quantitative characteristics of the macular vessel density (VD) and foveal avascular zone (FAZ) in glaucoma using optical coherence tomography angiography (OCT-A). Cross-sectional, age- and sex-matched case-control study. Fifty-two eyes of 52 patients with primary open angle glaucoma and 52 eyes from 52 healthy participants were recruited retrospectively. OCT-A was performed on a 3 x 3-mm macular region centered on the fovea. OCT-A scans were manually graded to define the FAZ. Parafoveal VD in superficial and deep retina were analyzed in the circular- and quadrant-segmented zone. The FAZ parameters included size, perimeter, and circularity index. The regression analysis among VD and FAZ-related parameters and ocular parameters was performed, and the diagnostic ability was calculated with refractive error adjusted. For both groups, the mean age and the sex ratio was not different between groups. With refractive error adjusted, the average macular VD was lower in glaucoma than in the control group for superficial (P = 0.013), deep (P<0.001), and the whole retina (P = 0.002). There were increased FAZ perimeter and decreased FAZ circularity index in glaucoma when compared with controls (P<0.001). In the multivariate regression models, FAZ circularity index were significantly associated with decreased peripapillary RNFL thickness (P = 0.007) and macular GCIPL thickness (P = 0.009) measured by OCT. The refractive-error adjusted area under receiver operating characteristics was highest for FAZ circularity index (0.905; 95% CI, 0.844-0.966), followed by temporal deep retinal VD (0.870; 95% CI, 0.803-0.937) and FAZ perimeter (0.858; 95% CI, 0.784-0.932). Decreased macular VD, increased FAZ perimeter, and decreased FAZ circularity index were observed in eyes with glaucoma using OCT-A. With refractive error adjusted, these parameters showed considerable diagnostic value for glaucoma. FAZ circularity index may be a novel biomarker representing disruption of the parafoveal capillary network in glaucoma, as supported by its association with structural parameters.
Objective The study aimed to evaluate the quantitative characteristics of the macular vessel density (VD) and foveal avascular zone (FAZ) in glaucoma using optical coherence tomography angiography (OCT-A). Design Cross-sectional, age- and sex-matched case–control study. Methods Fifty-two eyes of 52 patients with primary open angle glaucoma and 52 eyes from 52 healthy participants were recruited retrospectively. OCT-A was performed on a 3 x 3-mm macular region centered on the fovea. OCT-A scans were manually graded to define the FAZ. Parafoveal VD in superficial and deep retina were analyzed in the circular- and quadrant-segmented zone. The FAZ parameters included size, perimeter, and circularity index. The regression analysis among VD and FAZ-related parameters and ocular parameters was performed, and the diagnostic ability was calculated with refractive error adjusted. Results For both groups, the mean age and the sex ratio was not different between groups. With refractive error adjusted, the average macular VD was lower in glaucoma than in the control group for superficial (P = 0.013), deep (P<0.001), and the whole retina (P = 0.002). There were increased FAZ perimeter and decreased FAZ circularity index in glaucoma when compared with controls (P<0.001). In the multivariate regression models, FAZ circularity index were significantly associated with decreased peripapillary RNFL thickness (P = 0.007) and macular GCIPL thickness (P = 0.009) measured by OCT. The refractive-error adjusted area under receiver operating characteristics was highest for FAZ circularity index (0.905; 95% CI, 0.844–0.966), followed by temporal deep retinal VD (0.870; 95% CI, 0.803–0.937) and FAZ perimeter (0.858; 95% CI, 0.784–0.932). Conclusions Decreased macular VD, increased FAZ perimeter, and decreased FAZ circularity index were observed in eyes with glaucoma using OCT-A. With refractive error adjusted, these parameters showed considerable diagnostic value for glaucoma. FAZ circularity index may be a novel biomarker representing disruption of the parafoveal capillary network in glaucoma, as supported by its association with structural parameters.
Audience Academic
Author Shin, Joong Won
Choi, Jaewan
Kook, Michael S
Kwon, Junki
Lee, Saem
Lee, Jiyun
AuthorAffiliation 2 Department of Ophthalmology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Republic of Korea
Bascom Palmer Eye Institute, UNITED STATES
1 Central Seoul Eye Center, Seoul, Republic of Korea
AuthorAffiliation_xml – name: 1 Central Seoul Eye Center, Seoul, Republic of Korea
– name: 2 Department of Ophthalmology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Republic of Korea
– name: Bascom Palmer Eye Institute, UNITED STATES
Author_xml – sequence: 1
  givenname: Jaewan
  surname: Choi
  fullname: Choi, Jaewan
  organization: Central Seoul Eye Center, Seoul, Republic of Korea
– sequence: 2
  givenname: Junki
  surname: Kwon
  fullname: Kwon, Junki
  organization: Department of Ophthalmology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Republic of Korea
– sequence: 3
  givenname: Joong Won
  surname: Shin
  fullname: Shin, Joong Won
  organization: Department of Ophthalmology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Republic of Korea
– sequence: 4
  givenname: Jiyun
  surname: Lee
  fullname: Lee, Jiyun
  organization: Department of Ophthalmology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Republic of Korea
– sequence: 5
  givenname: Saem
  surname: Lee
  fullname: Lee, Saem
  organization: Central Seoul Eye Center, Seoul, Republic of Korea
– sequence: 6
  givenname: Michael S
  orcidid: 0000-0001-7407-596X
  surname: Kook
  fullname: Kook, Michael S
  organization: Department of Ophthalmology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Republic of Korea
BackLink https://www.ncbi.nlm.nih.gov/pubmed/28934255$$D View this record in MEDLINE/PubMed
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ContentType Journal Article
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2017 Choi et al 2017 Choi et al
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– notice: 2017 Choi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.
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Competing Interests: The authors have declared that no competing interests exist.
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Snippet The study aimed to evaluate the quantitative characteristics of the macular vessel density (VD) and foveal avascular zone (FAZ) in glaucoma using optical...
Objective The study aimed to evaluate the quantitative characteristics of the macular vessel density (VD) and foveal avascular zone (FAZ) in glaucoma using...
OBJECTIVEThe study aimed to evaluate the quantitative characteristics of the macular vessel density (VD) and foveal avascular zone (FAZ) in glaucoma using...
OBJECTIVE:The study aimed to evaluate the quantitative characteristics of the macular vessel density (VD) and foveal avascular zone (FAZ) in glaucoma using...
Objective The study aimed to evaluate the quantitative characteristics of the macular vessel density (VD) and foveal avascular zone (FAZ) in glaucoma using...
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SubjectTerms Adjustment
Adult
Aged
Analysis
Angiography
Bioindicators
Biology and Life Sciences
Biomarkers
Case-Control Studies
Circularity
Coherence
Control methods
Cross-Sectional Studies
Diabetes
Diabetic retinopathy
Diagnostic systems
Disruption
Error analysis
Errors
Eye
Eye (anatomy)
Fluorescein Angiography
Fovea
Fovea Centralis - blood supply
Fovea Centralis - pathology
Glaucoma
Glaucoma, Open-Angle - physiopathology
Health aspects
Humans
Hypoxia
Macula Lutea - blood supply
Macula Lutea - pathology
Male
Medical imaging
Medicine
Medicine and Health Sciences
Middle Aged
Optical Coherence Tomography
Optical tomography
Optics
Patients
Physical Sciences
Physiological aspects
Regression analysis
Regression models
Research and Analysis Methods
Retina
Retrospective Studies
Sex
Sex ratio
Tomography
Tomography, Optical Coherence - methods
Veins & arteries
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Title Quantitative optical coherence tomography angiography of macular vascular structure and foveal avascular zone in glaucoma
URI https://www.ncbi.nlm.nih.gov/pubmed/28934255
https://www.proquest.com/docview/1941349951/abstract/
https://search.proquest.com/docview/1942683828
https://pubmed.ncbi.nlm.nih.gov/PMC5608222
https://doaj.org/article/e04cda7842b64d3f99ba2015cea15341
http://dx.doi.org/10.1371/journal.pone.0184948
Volume 12
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