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Long-term reproducibility of optical coherence tomography angiography in healthy and stable glaucomatous eyes
  1. Takashi Nishida1,
  2. Sasan Moghimi1,
  3. Huiyuan Hou1,
  4. James A Proudfoot1,
  5. Aimee C Chang1,
  6. Ryan Caezar C David1,
  7. Alireza Kamalipour1,
  8. Nevin El-Nimri1,
  9. Jasmin Rezapour1,2,
  10. Christopher Bowd1,
  11. Linda M Zangwill1,
  12. Robert N Weinreb1
  1. 1Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California, USA
  2. 2Department of Ophthalmology, University Medical Centre of the Johannes Gutenberg University Mainz, Mainz, Germany
  1. Correspondence to Dr Robert N Weinreb, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, USA; rweinreb{at}


Background/aims To assess and compare long-term reproducibility of optic nerve head (ONH) and macula optical coherence tomography angiography (OCTA) vascular parameters and optical coherence tomography (OCT) thickness parameters in stable primary open-angle glaucoma (POAG), glaucoma suspect and healthy eyes.

Methods Eighty-eight eyes (15 healthy, 38 glaucoma suspect and 35 non-progressing POAG) of 68 subjects who had at least three visits within 1–1.5 years with OCTA and OCT imaging (Angiovue; Optovue, Fremont, California, USA) on the same day were included. A series of vascular and thickness parameters were measured including macular parafoveal vessel density (pfVD), ONH circumpapillary capillary density (cpCD), macular parafoveal ganglion cell complex (pfGCC) and ONH circumpapillary retinal nerve fibre layer (cpRNFL). A random effects analysis of variance model was used to estimate intraclass correlation (ICC) coefficients and long-term variability estimates.

Results ICC was lower for OCTA (pfVD 0.823 (95% CI 0.736 to 0.888) and cpCD 0.871 (0.818 to 0.912)) compared with OCT (pfGCC 0.995 (0.993 to 0.997) and cpRNFL 0.975 (0.964 to 0.984)). Within-subject test–retest SD was 1.17% and 1.22% for pfVD and cpCD, and 0.57 and 1.22 µm for pfGCC and cpRNFL. Older age and lower signal strength index were associated with decreasing long-term variability of vessel densities.

Conclusions OCTA-measured macula and ONH vascular parameters have good long-term reproducibility, supporting the use of this instrument for longitudinal analysis. OCTA long-term reproducibility is less than OCT-measured thickness reproducibility. This needs to be taken into consideration when serial OCTA images are evaluated for change.

Trial registration number NCT00221897.

  • glaucoma
  • imaging
  • intraocular pressure
  • macula

Data availability statement

Data are available upon reasonable request. The datasets generated and/or analysed during the current study are available from the corresponding author on reasonable request.

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Data availability statement

Data are available upon reasonable request. The datasets generated and/or analysed during the current study are available from the corresponding author on reasonable request.

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  • TN and SM are joint first authors.

  • TN and SM contributed equally.

  • Contributors Involved in design and conduct of study: TN and SM. Data collection: TN, SM, HH, RCCD, AK, NE-N, CB and JR. Analysis and interpretation of data: TN, SM, JAP and RNW. Writing: TN, SM, ACC and RNW. Critical revision: TN, SM, LMZ and RNW. Approval of the manuscript: TN, SM, HH, JAP, ACC, RCCD, AK, NE-N, JR, CB, LMZ and RNW. RNW had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

  • Funding National Institutes of Health/National Eye Institute Grants R01EY029058, R01EY011008, U10EY14267, R01EY026574, R01EY019869 and R01EY027510; Core Grant P30EY022589; an Unrestricted Grant (no grant number) from Research to Prevent Blindness (New York, NY); UC Tobacco Related Disease Research Programme (T31IP1511); German Research Foundation (DFG, research fellowship grant RE 4155/1-1); and grants for participants’ glaucoma medications from Alcon, Allergan, Pfizer, Merck and Santen.

  • Disclaimer The sponsor or funding organisations had no role in the design or conduct of this research.

  • 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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