Quantitative Optical Coherence Tomography Angiography of Radial Peripapillary Capillaries in Glaucoma, Glaucoma Suspect, and Normal Eyes

Am J Ophthalmol. 2016 Oct:170:41-49. doi: 10.1016/j.ajo.2016.07.015. Epub 2016 Jul 25.

Abstract

Purpose: To evaluate the quantitative characteristics of the radial peripapillary capillary (RPC) network in glaucoma, glaucoma suspect, and normal eyes using speckle variance optical coherence tomography angiography (OCT-A). To determine correlations between RPC density, nerve fiber layer (NFL) thickness, and visual field indices.

Design: Cross-sectional study.

Methods: OCT-A images of RPCs were acquired at a single institution using a custom-built 1060 nm system from 3 groups: unilateral glaucoma (10 eyes from 5 subjects), glaucoma suspects (6 eyes from 3 subjects), and normal control eyes (16 eyes from 9 normal subjects). Peripapillary NFL thickness measurements were determined using spectral-domain optical coherence tomography. Glaucoma and glaucoma suspects also underwent automated 30-2 Humphrey visual field analysis. Manual tracing techniques were used to quantify RPC density in the OCT-A images. Data were analyzed using a linear mixed model with 1 fixed-effect covariate. Correlations between main outcome measures (RPC density, NFL thickness, and visual field index) were determined.

Results: Mean age was not significantly different between the 3 groups (P = .25). The density of RPCs was significantly lower in glaucomatous eyes compared with matched-peripapillary regions in the fellow eye, glaucoma suspect group, and normal group (all P < .001). RPC density was strongly correlated with NFL thickness (P < .001) and visual field index (P < .001).

Conclusions: Significant reductions in RPC density were correlated with sites of NFL decrease and visual field loss in glaucoma. Speckle variance OCT-A allows visualization and quantification of RPCs and may therefore be a useful tool for indirectly quantifying and monitoring retinal ganglion cell axonal injury in glaucoma.

MeSH terms

  • Adult
  • Aged
  • Capillaries / diagnostic imaging
  • Capillaries / pathology
  • Cross-Sectional Studies
  • Female
  • Fluorescein Angiography / methods*
  • Glaucoma / physiopathology*
  • Healthy Volunteers
  • Humans
  • Intraocular Pressure
  • Male
  • Middle Aged
  • Nerve Fibers / pathology
  • Ocular Hypertension / physiopathology
  • Optic Disk / blood supply*
  • Retinal Ganglion Cells / pathology
  • Retinal Vessels / diagnostic imaging
  • Retinal Vessels / pathology*
  • Tomography, Optical Coherence / methods*
  • Visual Fields / physiology
  • Young Adult