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OCT-angiography detects longitudinal microvascular changes in glaucoma: a systematic review
  1. Ana Miguel1,2,
  2. André Silva2,3,
  3. Joao Barbosa-Breda4,5,6,
  4. Luis Azevedo2,
  5. Abdulkarim Abdulrahman7,
  6. Esther Hereth8,
  7. Luis Abegão Pinto9,10,
  8. Yves Lachkar8,
  9. Ingeborg Stalmans6,11
  1. 1 Ophthalmology, Hôpital Privé de la Baie, Saint-Martin-des-Champs, France
  2. 2 Faculty of Medicine of Oporto, Centre for Research in Health Technologies and Information (CINTESIS), Oporto, Portugal
  3. 3 Department of Ophthalmology, Hospital São Teotónio, Viseu, Portugal, Porto, Portugal
  4. 4 Ophthalmology, Centro Hospitalar São João, Porto, Porto, Portugal
  5. 5 Cardiovascular R&D Center, Faculty of Medicine of the University of Porto, Porto, Portugal
  6. 6 Department of Neurosciences, KULeuven, Research Group Ophthalmology, Leuven, Belgium
  7. 7 Cardiology, Mohammed bin Khalifa Cardiac Centre, Awali, Bahrain
  8. 8 Ophthalmology, Fondation Hopital Saint Joseph, Paris, Île-de-France, France
  9. 9 Department of Pharmacology and Neurosciences, Faculty of Medicine of Lisbon University, Lisbon, Portugal
  10. 10 Department of Ophthalmology, Centro Hospitalar e Universitário Lisboa Norte, Lisbon, Portugal
  11. 11 Ophthalmology, KU Leuven University Hospitals Leuven, Leuven, Flanders, Belgium
  1. Correspondence to Professor Ana Miguel, Ophthalmology, Polyclinique de la Baie Saint Martin, Saint-Martin-des-Champs 50300, France; myworld_ana{at}


Background/aims Optical coherence tomography angiography (OCTA) allows the study of vessel density (VD). We intended to perform a systematic review of studies focusing on longitudinal changes in peripapillary and macular VD measurements in glaucoma.

Methods A search was performed across MEDLINE, Scopus, ISI Web of Science and Google Scholar, using the following query from inception until 20 September 2019: ((“optical coherence tomography angiography”[tiab]) OR (optical coherence tomography angiography[MeSH]) OR (“OCTA”[tiab]) OR (“OCT-A”[tiab]) OR (“angio-OCT”[tiab]) OR (“OCT- angiography”[tiab]) OR (“OCT-angio”[tiab]) OR (“OCT-angiographie”[tiab])) AND (glaucom*[tiab] OR glaucoma[MeSH]). Prospective studies that quantitatively assessed the longitudinal changes in VD in glaucoma with at least 3 months of follow-up were included.

Results Ten out of 4516 studies were included. The rate of VD change in glaucoma varied from 0.036/year to 1.08/year and 1.3% to 3.2% per year, with significantly different rates between glaucoma and healthy controls. Five studies assessed VD change after glaucoma surgery, obtaining variable results, ranging from a temporary VD decrease to increase after 3 months. Meta-analysis was not possible due to a wide variation in methods, measurements and region of VD.

Conclusion OCTA is a non-invasive technology, which shows promise in glaucoma. Measures should be taken to increase the quality and standardise the methodology of VD measures in OCTA longitudinal studies, for future meta-analyses.

  • glaucoma
  • imaging

Data availability statement

Data are available upon reasonable request. Available at request.

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Data availability statement

Data are available upon reasonable request. Available at request.

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  • AM and AS are joint first authors.

  • AM and AS contributed equally.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

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

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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