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Repeatability and comparability of peripapillary vessel density measurements of high-density and non-high-density optical coherence tomography angiography scans in normal and glaucoma eyes
  1. Jayasree P Venugopal1,
  2. Harsha Laxmana Rao1,2,
  3. Robert N Weinreb3,
  4. Srilakshmi Dasari2,
  5. Mohammed Riyazuddin2,
  6. Zia Sultan Pradhan1,
  7. Narendra K Puttaiah1,2,
  8. Sathi Devi1,
  9. Kaweh Mansouri4,5,
  10. Carroll A B Webers6
  1. 1 Glaucoma Services, Narayana Nethralaya, Rajajinagar, Bangalore, India
  2. 2 Glaucoma Services, Narayana Nethralaya, Hulimavu, Bangalore, India
  3. 3 Hamilton Glaucoma Center and Department of Ophthalmology, Shiley Eye Institute, University of California, La Jolla, California, USA
  4. 4 Glaucoma Center, Montchoisi Clinic, Swiss Vision Network, Lausanne, Switzerland
  5. 5 Department of Ophthalmology, University of Colorado, Denver, Colorado, USA
  6. 6 University Eye Clinic Maastricht, University Medical Center, Maastricht, The Netherlands
  1. Correspondence to Dr Harsha Laxmana Rao, Narayana Nethralaya, Bangalore 560076, India; harshalaxmanarao{at}gmail.com

Abstract

Aims To compare the peripapillary vessel density (VD) measurements of high-density (HD) and non-HD optical coherence tomography angiography (OCTA) scans in normal and glaucoma eyes, and to evaluate the intrasession repeatability of VD measurements of HD scans.

Methods In a cross-sectional study, 46 normal (33 subjects) and 89 glaucoma (64 patients) eyes underwent 3 HD and 1 non-HD optic nerve head OCTA scans in the same session. Agreement in VD measurements between HD and non-HD scans was assessed using Bland and Altman analysis. Repeatability of the VD measurements of HD scans was assessed using within-subject coefficient of repeatability (CRw) and variation (CVw).

Results The mean difference in the VDs ranged between 0.7% (temporal sector VD) and 2.0% (inferonasal sector VD), with HD scans showing significantly greater VD values than non-HD scans. The 95% limits of agreement (LoA) in glaucoma eyes ranged between −2.0% and 5.0% for whole enface VD and between −4.8% and 9.6% for superotemporal VD. CRw (%) and CVw (%) of VD measurements of HD scans ranged from 3.0 to 4.9 and from 2.0 to 3.1 in normal eyes. The same ranged from 3.2 to 6.7 and from 2.6 to 4.8, respectively, in glaucoma eyes.

Conclusions VD of HD scans was higher than that of non-HD scans. The wide 95% LoA indicates that the VD measurements of HD and non-HD scans cannot be used interchangeably. Test–retest repeatability of VDs on HD scans was as high as 6%. These results should be considered while using OCTA for longitudinal evaluation of glaucoma.

  • glaucoma
  • optical coherence tomography angiography
  • high-density scan
  • peripapillary vessel density
  • agreement
  • repeatability
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Footnotes

  • Contributors JPV 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, and acquisition and interpretation of data; (2) revising it critically for important intellectual content; and (3) final approval of the version to be published.

  • Funding This study was funded by http://dx.doi.org/10.13039/100001818 Research to Prevent Blindness http://dx.doi.org/10.13039/100000053 National Eye Institute (grant number: R01 EY029058 (RNW)).

  • Competing interests None declared.

  • Ethics approval The methodology adhered to the tenets of the Declaration of Helsinki for research involving human subjects. The study was approved by the Ethics Committee of Narayana Nethralaya.

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

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