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Diagnostic ability of peripapillary vessel density measurements of optical coherence tomography angiography in primary open-angle and angle-closure glaucoma
  1. Harsha L Rao1,
  2. Sujatha V Kadambi1,
  3. Robert N Weinreb2,
  4. Narendra K Puttaiah1,
  5. Zia S Pradhan1,
  6. Dhanaraj A S Rao1,
  7. Rajesh S Kumar1,
  8. Carroll A B Webers3,
  9. Rohit Shetty1
  1. 1Narayana Nethralaya, Rajajinagar, Bangalore, India
  2. 2Shiley Eye Institute, Hamilton Glaucoma Center and Department of Ophthalmology, University of California, San Diego, 9500 Gilman Drive, La Jolla, California, USA
  3. 3University Eye Clinic Maastricht, University Medical Center, Maastricht, The Netherlands
  1. Correspondence to Dr Harsha L Rao, Narayana Nethralaya, 121/C, Chord Road, 1st ‘R’ Block, Rajajinagar, Bangalore 560010, India; harshalaxmanarao{at}gmail.com

Abstract

Aims To evaluate the diagnostic ability of peripapillary vessel density measurements on optical coherence tomography angiography (OCTA) in primary open-angle glaucoma (POAG) and primary angle-closure glaucoma (PACG), and to compare these with peripapillary retinal nerve fibre layer (RNFL) thickness measurements.

Methods In a cross-sectional study, 48 eyes of 33 healthy control subjects, 63 eyes of 39 patients with POAG and 49 eyes of 32 patients with PACG underwent OCTA (RTVue-XR, Optovue, Fremont, California, USA) and RNFL imaging with spectral domain OCT. Diagnostic abilities of vessel density and RNFL parameters were evaluated using area under receiver operating characteristic curves (AUC) and sensitivities at fixed specificities.

Results AUCs of peripapillary vessel density ranged between 0.48 for the temporal sector and 0.88 for the inferotemporal sector in POAG. The same in PACG ranged between 0.57 and 0.86. Sensitivities at 95% specificity ranged from 13% to 70% in POAG, and from 10% to 67% in PACG. AUCs of peripapillary RNFL thickness ranged between 0.51 for the temporal sector and 0.91 for the inferonasal sector in POAG. The same in PACG ranged between 0.61 and 0.87. Sensitivities at 95% specificity ranged from 8% to 68% in POAG, and from 2% to 67% in PACG. AUCs of all peripapillary vessel density measurements were comparable (p>0.05) to the corresponding RNFL thickness measurements in both POAG and PACG.

Conclusions Diagnostic ability of peripapillary vessel density parameters of OCTA, especially the inferotemporal sector measurement, was good in POAG and PACG. Diagnostic abilities of vessel density measurements were comparable to RNFL measurements in both POAG and PACG.

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Footnotes

  • Contributors HLR was involved in (1) conception and design, acquisition of data, or analysis and interpretation of data; (2) drafting the article or revising it critically for important intellectual content; and (3) final approval of the version to be published. All the authors have contributed substantially to (1) conception and design, acquisition and interpretation of data; (2) revising it critically for important intellectual content; and (3) final approval of the version to be published.

  • Competing interests HLR is a consultant for Pfizer and Cipla, RNW is a consultant for Aerie Pharmaceuticals, Allergan, Alcon, Bausch & Lomb, Forsight Vision V, and Unity, and CABW is a consultant for Alcon, Allergan, MSD and Pfizer. RNW has received financial support in form of instruments or research funding from Topcon, Carl Zeiss, Neurovision, Optos, Heidelberg Engineering, Genentech and Quark.

  • Ethics approval Obtained from the Ethics Committee of Narayana Nethralaya.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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