Optical coherence tomography angiography vessel density mapping at various retinal layers in healthy and normal tension glaucoma eyes

PurposeTo investigate peripapillary vessel density at various spatial locations and layers in healthy and normal tension glaucoma eyes using optical coherence tomography angiography (OCTA).MethodsA commercial OCTA device (AngioPlex; Carl Zeiss Meditec) was used to image microvasculature in a 6 × 6-mm optic disc region. Vessel densities of superficial and deep retinal layers were calculated using an automatic thresholding algorithm. Vessel density maps were plotted by averaging individual angiogram images. The spatial characteristics of vessel densities were analyzed at clock-hour sectors and in five 0.7-mm-thick concentric circles from a diameter of 2.0 to 5.5 mm. Areas under the receiver operating characteristics curves (AUCs) assessed the glaucoma diagnostic ability.ResultsVessel density maps of superficial and deep retinal layers were significantly reduced at the 7 and 11 o’clock positions in glaucomatous eyes. In superficial layer, vessel density significantly decreased as the distance from the optic disc margin increased, except in the innermost circle (2.0–2.7-mm). There were significant differences in AUCs of superficial vessel density between innermost circle and the other outer circles. In the deep layer, the innermost circle showed significantly higher vessel density than the outer circles. Vessel density at 7 o’clock showed the best diagnostic performance (AUCs, 0.898 and 0.789) both in the superficial and deep layers. The innermost circle showed eccentric feature compared to the outer circles in terms of spatial characteristics and diagnostic ability.ConclusionsUnderstanding of the spatial characteristics of peripapillary vasculature may be helpful in clinical practice and determining the optimal measurement area of vessel density.

[1]  J. J. Wang,et al.  The relationship between glaucoma and myopia: the Blue Mountains Eye Study. , 1999, Ophthalmology.

[2]  Douglas R. Anderson,et al.  Determinants of normal retinal nerve fiber layer thickness measured by Stratus OCT. , 2007, Ophthalmology.

[3]  Paul Mitchell,et al.  Retinal vessel diameter and open-angle glaucoma: the Blue Mountains Eye Study. , 2005, Ophthalmology.

[4]  Martin F. Kraus,et al.  Optical coherence tomography angiography of optic disc perfusion in glaucoma. , 2014, Ophthalmology.

[5]  E. Stefánsson,et al.  The impact of ocular blood flow in glaucoma , 2002, Progress in Retinal and Eye Research.

[6]  R. Spaide,et al.  Retinal vascular layers imaged by fluorescein angiography and optical coherence tomography angiography. , 2015, JAMA ophthalmology.

[7]  A L Kornzweig,et al.  Selective atrophy of the radial peripapillary capillaries in chronic glaucoma. , 1968, Archives of ophthalmology.

[8]  G. Seong,et al.  Prevalence of primary open-angle glaucoma in central South Korea the Namil study. , 2011, Ophthalmology.

[9]  David Huang,et al.  Optical Coherence Tomography Angiography Vessel Density in Healthy, Glaucoma Suspect, and Glaucoma Eyes , 2016, Investigative ophthalmology & visual science.

[10]  Xiulan Zhang,et al.  Microvascular Density in Glaucomatous Eyes With Hemifield Visual Field Defects: An Optical Coherence Tomography Angiography Study. , 2016, American journal of ophthalmology.

[11]  T. Wong,et al.  Refractive error, axial dimensions, and primary open-angle glaucoma: the Singapore Malay Eye Study. , 2010, Archives of ophthalmology.

[12]  Guohua Shi,et al.  Correlation between optic disc perfusion and glaucomatous severity in patients with open-angle glaucoma: an optical coherence tomography angiography study , 2015, Graefe's Archive for Clinical and Experimental Ophthalmology.

[13]  Dao-Yi Yu,et al.  Correlation of histologic and clinical images to determine the diagnostic value of fluorescein angiography for studying retinal capillary detail. , 2010, Investigative ophthalmology & visual science.

[14]  C. Kee,et al.  The distribution of intraocular pressure in urban and in rural populations: the Namil study in South Korea. , 2012, American journal of ophthalmology.

[15]  K. Gitter,et al.  Presumed macular choroidal watershed vascular filling, choroidal neovascularization, and systemic vascular disease in patients with age-related macular degeneration. , 1998, American journal of ophthalmology.

[16]  Douglas R. Anderson,et al.  Ability of cirrus HD-OCT optic nerve head parameters to discriminate normal from glaucomatous eyes. , 2011, Ophthalmology.

[17]  Gadi Wollstein,et al.  OCT for glaucoma diagnosis, screening and detection of glaucoma progression , 2013, British Journal of Ophthalmology.

[18]  Ruikang K. Wang,et al.  Optic Disc Perfusion in Primary Open Angle and Normal Tension Glaucoma Eyes Using Optical Coherence Tomography-Based Microangiography , 2016, PloS one.

[19]  S. Kishi,et al.  Watershed zone in the human peripheral choroid. , 1996, Ophthalmology.

[20]  Ruikang K. Wang,et al.  Optical microangiography provides correlation between microstructure and microvasculature of optic nerve head in human subjects , 2012, Journal of biomedical optics.

[21]  Liang Xu,et al.  Retinal vessel diameter in normal and glaucomatous eyes: the Beijing eye study , 2007, Clinical & experimental ophthalmology.

[22]  Dao-Yi Yu,et al.  Correlation between the radial peripapillary capillaries and the retinal nerve fibre layer in the normal human retina. , 2014, Experimental eye research.

[23]  G. Holló Vessel Density Calculated from OCT Angiography in 3 Peripapillary Sectors in Normal, Ocular Hypertensive, and Glaucoma Eyes , 2016, European journal of ophthalmology.

[24]  T. Son,et al.  Sensitivity enhancement of intrinsic optical signal recording through split-spectrum-optical coherence tomography , 2016 .

[25]  S. Hayreh In vivo choroidal circulation and its watershed zones , 1990, Eye.

[26]  S. Uzun,et al.  Vascular Density in Retina and Choriocapillaris as Measured by Optical Coherence Tomography Angiography. , 2016, American journal of ophthalmology.

[27]  David R Williams,et al.  In-vivo imaging of retinal nerve fiber layer vasculature: imaging - histology comparison , 2009, BMC ophthalmology.

[28]  M. C. Leske,et al.  Risk factors for open-angle glaucoma. The Barbados Eye Study. , 1995, Archives of ophthalmology.

[29]  P. Henkind,et al.  Radial peripapillary capillaries of the retina. I. Anatomy: human and comparative. , 1967, The British journal of ophthalmology.

[30]  Ruikang K. Wang,et al.  Methods and algorithms for optical coherence tomography-based angiography: a review and comparison , 2015, Journal of biomedical optics.

[31]  Ruikang K. Wang,et al.  Minimizing projection artifacts for accurate presentation of choroidal neovascularization in OCT micro-angiography. , 2015, Biomedical optics express.

[32]  David Huang,et al.  Optical Coherence Tomography Angiography of the Peripapillary Retina in Glaucoma. , 2015, JAMA ophthalmology.

[33]  J. Jonas,et al.  High myopia and glaucoma susceptibility the Beijing Eye Study. , 2007, Ophthalmology.

[34]  David Huang,et al.  Projection-resolved optical coherence tomographic angiography. , 2016, Biomedical optics express.

[35]  D. T. Liu,et al.  Choroidal thickness measurement in myopic eyes by enhanced depth optical coherence tomography. , 2013, Ophthalmology.

[36]  B. Bengtsson,et al.  Performance of time-domain and spectral-domain Optical Coherence Tomography for glaucoma screening , 2012, Acta ophthalmologica.

[37]  L. Kagemann,et al.  Peripapillary retinal blood flow in normal tension glaucoma , 1999, The British journal of ophthalmology.

[38]  P Henkind,et al.  Radial peripapillary capillaries of the retina. II. Possible role in Bjerrum scotoma. , 1968, The British journal of ophthalmology.

[39]  S. Hayreh Posterior ciliary artery circulation in health and disease: the Weisenfeld lecture. , 2004, Investigative ophthalmology & visual science.

[40]  R. Klein,et al.  Refractive errors, intraocular pressure, and glaucoma in a white population. , 2003, Ophthalmology.

[41]  E. DeLong,et al.  Comparing the areas under two or more correlated receiver operating characteristic curves: a nonparametric approach. , 1988, Biometrics.

[42]  M. Shahidi,et al.  Thickness of the peripapillary retina in healthy subjects with different degrees of ametropia. , 2000, Ophthalmology.

[43]  Dao-Yi Yu,et al.  Retinal ganglion cells: Energetics, compartmentation, axonal transport, cytoskeletons and vulnerability , 2013, Progress in Retinal and Eye Research.

[44]  J. Shin,et al.  Choroidal thickness and volume mapping by a six radial scan protocol on spectral-domain optical coherence tomography. , 2012, Ophthalmology.

[45]  R. Sergott,et al.  Color Doppler analysis of ocular vessel blood velocity in normal-tension glaucoma. , 1994, American journal of ophthalmology.

[46]  Hui Rong Zhang,et al.  Scanning electron-microscopic study of corrosion casts on retinal and choroidal angioarchitecture in man and animals , 1994, Progress in Retinal and Eye Research.

[47]  A. Ho,et al.  In Vivo Assessment of Macular Vascular Density in Healthy Human Eyes Using Optical Coherence Tomography Angiography. , 2016, American journal of ophthalmology.

[48]  Marinko V Sarunic,et al.  Quantitative Optical Coherence Tomography Angiography of Radial Peripapillary Capillaries in Glaucoma, Glaucoma Suspect, and Normal Eyes. , 2016, American journal of ophthalmology.