Optic Disc Perfusion in Primary Open Angle and Normal Tension Glaucoma Eyes Using Optical Coherence Tomography-Based Microangiography

• Published in: PloS one Vol. 11; no. 5; p. e0154691
• Main Authors: Bojikian, Karine D., Chen, Chieh-Li, Wen, Joanne C., Zhang, Qinqin, Xin, Chen, Gupta, Divakar, Mudumbai, Raghu C., Johnstone, Murray A., Wang, Ruikang K., Chen, Philip P.
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 05.05.2016; Public Library of Science (PLoS)
• Subjects: Analysis; Angiography; Angiography - methods; Bioengineering; Biology and Life Sciences; Care and treatment; Case-Control Studies; Cataracts; Correlation analysis; Defects; Development and progression; Diagnosis; Eye; Eye (anatomy); Flow velocity; Fluctuations; Fluorescein angiography; Flux; Glaucoma; Glaucoma, Open-Angle - diagnostic imaging; Glaucoma, Open-Angle - physiopathology; Humans; Image processing; Image segmentation; Intraocular pressure; Investigations; Low Tension Glaucoma - diagnostic imaging; Low Tension Glaucoma - physiopathology; Medical imaging; Medicine and Health Sciences; Microvasculature; Migraine; Observational studies; Optic Disk - blood supply; Optic nerve; Optical Coherence Tomography; Optics; Perfusion; Research and Analysis Methods; Retina; Risk factors; Tension; Thickness; Tomography; Tomography, Optical Coherence - methods; Visual field; Visual fields
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0154691

To investigate optic disc perfusion differences in normal, primary open-angle glaucoma (POAG), and normal tension glaucoma (NTG) eyes using optical microangiography (OMAG) based optical coherence tomography (OCT) angiography technique. Cross-sectional, observational study. Twenty-eight normal, 30 POAG, and 31 NTG subjects. One eye from each subject was scanned with a 68 kHz Cirrus HD-OCT 5,000-based OMAG prototype system centered at the optic nerve head (ONH) (Carl Zeiss Meditec Inc, Dublin, CA). Microvascular images were generated from the OMAG dataset by detecting the differences in OCT signal between consecutive B-scans. The pre-laminar layer (preLC) was isolated by a semi-automatic segmentation program. Optic disc perfusion, quantified as flux, vessel area density, and normalized flux (flux normalized by the vessel area) within the ONH. Glaucomatous eyes had significantly lower optic disc perfusion in preLC in all three perfusion metrics (p<0.0001) compared to normal eyes. The visual field (VF) mean deviation (MD) and pattern standard deviation (PSD) were similar between the POAG and NTG groups, and no differences in optic disc perfusion were observed between POAG and NTG. Univariate analysis revealed significant correlation between optic disc perfusion and VF MD, VF PSD, and rim area in both POAG and NTG groups (p≤0.0288). However, normalized optic disc perfusion was correlated with some structural measures (retinal nerve fiber layer thickness and ONH cup/disc ratio) only in POAG eyes. Optic disc perfusion detected with OMAG was significantly reduced in POAG and NTG groups compared to normal controls, but no difference was seen between POAG and NTG groups with similar levels of VF damage. Disc perfusion was significantly correlated with VF MD, VF PSD, and rim area in glaucomatous eyes. Vascular changes at the optic disc as measured using OMAG may provide useful information for diagnosis and monitoring of glaucoma.