TY - JOUR
T1 - Structural and Functional Associations of Macular Microcirculation in the Ganglion Cell-Inner Plexiform Layer in Glaucoma Using Optical Coherence Tomography Angiography
AU - Richter, Grace M.
AU - Madi, Ingy
AU - Chu, Zhongdi
AU - Burkemper, Bruce
AU - Chang, Ryuna
AU - Zaman, Arman
AU - Sylvester, Beau
AU - Reznik, Alena
AU - Kashani, Amir
AU - Wang, Ruikang K.
AU - Varma, Rohit
N1 - Funding Information:
Supported by an unrestricted grant to the Department of Ophthalmology from Research to Prevent Blindness (New York, NY). The National Institutes of Health (Grant 1K23EY027855-01, G.M.R.), American Glaucoma Society Mentoring for Advancement of Physician Scientists Grant (G.M.R.), and Carl Zeiss Meditec (Dublin, CA; SD-OCTA device).
Funding Information:
The authors wish to thank Lernik Torossian, OD and Veronica Isozaki, OD (USC Roski) for their assistance with patient recruitment for this study, Anoush Shahidzadeh,MPH for her image acquisition support (USC Roski), and Gary Lee, PhD, Carl Zeiss Meditec for HVF support.Supported by an unrestricted grant to the Department of Ophthalmology from Research to Prevent Blindness (New York, NY). The National Institutes of Health (Grant 1K23EY027855-01, G.M.R.), American Glaucoma SocietyMentoring for Advancement of Physician Scientists Grant (G.M.R.), and Carl Zeiss Meditec (Dublin, CA; SD-OCTA device).
Publisher Copyright:
© 2018 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2018
Y1 - 2018
N2 - Purpose: To quantify retinal microvasculature within the macular ganglion cell-inner plexiform layer (GCIPL) in primary open-angle glaucoma (POAG) and normal eyes, determine association of vessel parameters with structural and functional measures, and report diagnostic accuracy of vessel parameters. Methods: POAG and normal patients underwent 6×6 mm macula scans [Angioplex optical coherence tomography angiography (OCTA); Cirrus HD-OCT 5000]; and Humphrey Field Analyzer II-i 24-2 visual field (VF). Prototype software performed semiautomatic segmentation to create GCIPL en face images, and quantified vessel area density (VAD), vessel skeleton density (VSD), and vessel complexity index (VCI) for the macula (globally, hemifields, and 6 focal sectors). Linear regression assessed association of OCTA parameters with VF mean deviation (MD) and GCIPL thickness globally and focally. Results: A total of 34 POAG and 21 normal eyes were studied. VAD, VSD, and VCI were reduced in POAG versus normal (0.463 vs. 0.486, P=0.00029; 0.230 vs. 0.219, P=0.0014; 1.15 vs. 1.09, P=0.0044, respectively), with a trend of worsening with increased POAG severity. Reduced global VF MD was associated with reduced VAD and VCI, controlling for age and intereye correlation (P=0.0060, 0.0080; R 2 =0.205, 0.211). Both superior and inferior hemifield MD were associated with corresponding VAD, VSD, and VCI (all P<0.007; R 2 ranged from 0.12 to 0.29). Global GCIPL thickness was not associated with global OCTA parameters, and only inferior sector GCIPL thickness was associated with corresponding VAD, VSD, and VCI (P<0.05; R 2 ranged from 0.15 to 0.16). Area under curves for VAD, VSD, and VCI were fair to good (0.83, 0.79, 0.82; respectively; P<0.0001). Conclusions: Glaucomatous eyes had reduced GCIPL microcirculation. OCTA parameters had stronger associations with functional rather than structural measures of glaucoma. This observation deserves further study.
AB - Purpose: To quantify retinal microvasculature within the macular ganglion cell-inner plexiform layer (GCIPL) in primary open-angle glaucoma (POAG) and normal eyes, determine association of vessel parameters with structural and functional measures, and report diagnostic accuracy of vessel parameters. Methods: POAG and normal patients underwent 6×6 mm macula scans [Angioplex optical coherence tomography angiography (OCTA); Cirrus HD-OCT 5000]; and Humphrey Field Analyzer II-i 24-2 visual field (VF). Prototype software performed semiautomatic segmentation to create GCIPL en face images, and quantified vessel area density (VAD), vessel skeleton density (VSD), and vessel complexity index (VCI) for the macula (globally, hemifields, and 6 focal sectors). Linear regression assessed association of OCTA parameters with VF mean deviation (MD) and GCIPL thickness globally and focally. Results: A total of 34 POAG and 21 normal eyes were studied. VAD, VSD, and VCI were reduced in POAG versus normal (0.463 vs. 0.486, P=0.00029; 0.230 vs. 0.219, P=0.0014; 1.15 vs. 1.09, P=0.0044, respectively), with a trend of worsening with increased POAG severity. Reduced global VF MD was associated with reduced VAD and VCI, controlling for age and intereye correlation (P=0.0060, 0.0080; R 2 =0.205, 0.211). Both superior and inferior hemifield MD were associated with corresponding VAD, VSD, and VCI (all P<0.007; R 2 ranged from 0.12 to 0.29). Global GCIPL thickness was not associated with global OCTA parameters, and only inferior sector GCIPL thickness was associated with corresponding VAD, VSD, and VCI (P<0.05; R 2 ranged from 0.15 to 0.16). Area under curves for VAD, VSD, and VCI were fair to good (0.83, 0.79, 0.82; respectively; P<0.0001). Conclusions: Glaucomatous eyes had reduced GCIPL microcirculation. OCTA parameters had stronger associations with functional rather than structural measures of glaucoma. This observation deserves further study.
KW - function
KW - ganglion cell-inner plexiform layer
KW - macula
KW - optical coherence tomography angiography (OCTA)
KW - primary open-angle glaucoma
KW - structure
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U2 - 10.1097/IJG.0000000000000888
DO - 10.1097/IJG.0000000000000888
M3 - Article
C2 - 29394201
AN - SCOPUS:85044781714
SN - 1057-0829
VL - 27
SP - 281
EP - 290
JO - Journal of glaucoma
JF - Journal of glaucoma
IS - 3
ER -