A comparison of the diagnostic ability of vessel density and structural measurements of optical coherence tomography in primary open angle glaucoma

• Published in: PloS one Vol. 12; no. 3; p. e0173930
• Main Authors: Rao, Harsha L, Pradhan, Zia S, Weinreb, Robert N, Riyazuddin, Mohammed, Dasari, Srilakshmi, Venugopal, Jayasree P, Puttaiah, Narendra K, Rao, Dhanaraj A S, Devi, Sathi, Mansouri, Kaweh, Webers, Carroll A B
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 13.03.2017; Public Library of Science (PLoS)
• Subjects: Accuracy; Aged; Algorithms; Angiography; Bias; Biology and Life Sciences; Biometrics; Case-Control Studies; Comparative analysis; Cross-Sectional Studies; Defects; Density; Diagnosis; Diagnostic systems; Experts; Eye; Eye (anatomy); Family medical history; Female; Glaucoma; Glaucoma, Open-Angle - diagnostic imaging; Humans; Intraocular Pressure; Macula Lutea - diagnostic imaging; Male; Measurement methods; Medical diagnosis; Medical imaging; Medicine and Health Sciences; Middle Aged; Optic Disk - diagnostic imaging; Optic nerve; Optical Coherence Tomography; Optical tomography; Optics; Prospective Studies; Research and Analysis Methods; Retina; Retinal Ganglion Cells; Retinal Vessels - diagnostic imaging; ROC Curve; Sensitivity; Studies; Thickness measurement; Tomography; Tomography, Optical Coherence - methods
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0173930

To compare the diagnostic abilities of vessel density measurements of the optic nerve head (ONH), peripapillary and macular regions on optical coherence tomography (OCT) angiography in eyes with primary open angle glaucoma (POAG) with that of the ONH rim area, peripapillary retinal nerve fiber layer (RNFL) thickness and the macular ganglion cell complex (GCC) thickness measurements. In a cross sectional study, 78 eyes of 50 control subjects and 117 eyes of 67 POAG patients underwent vessel density and structural measurements with spectral domain OCT. POAG was diagnosed based on the masked evaluation of optic disc stereo photographs. Area under receiver operating characteristic curves (AUC) and sensitivities at fixed specificities of vessel densities in ONH, peripapillary and macular regions were compared with rim area, RNFL and GCC thickness. The AUC (sensitivity at 95% specificity) of average vessel densities within the ONH, peripapillary and macular region were 0.77 (31%), 0.85 (56%) and 0.70 (18%) respectively. The same of ONH rim area, average RNFL and GCC thickness were 0.94 (83%), 0.95 (72%) and 0.93 (62%) respectively. AUCs of vessel densities were significantly lower (p<0.05) than that of the corresponding structural measurements. Pre-treatment IOP (coefficient: 0.08) affected (p<0.05) the AUC of ONH vessel density but not of any other vessel density or structural measurements. Diagnostic abilities of ONH, peripapillary and the macular vessel densities in POAG were significantly lower than ONH rim area, peripapillary RNFL and macular GCC measurements respectively. At fixed levels of glaucoma severity, the diagnostic ability of the ONH vessel density was significantly greater in eyes with higher pre-treatment IOP.