RT Journal Article
SR Electronic
T1 Effect of algorithms and covariates in glaucoma diagnosis with optical coherence tomography angiography
JF British Journal of Ophthalmology
JO Br J Ophthalmol
FD BMJ Publishing Group Ltd.
SP 1703
OP 1709
DO 10.1136/bjophthalmol-2020-318677
VO 106
IS 12
A1 Qi Sheng You
A1 Ou Tan
A1 Shaohua Pi
A1 Liang Liu
A1 Ping Wei
A1 Aiyin Chen
A1 Eliesa Ing
A1 Yali Jia
A1 David Huang
YR 2022
UL http://bjo.bmj.com/content/106/12/1703.abstract
AB Purpose To assess the effects of algorithms and covariates in glaucoma diagnosis with optical coherence tomography angiography (OCTA).Methods In this prospective cross-sectional study, one eye each of 36 normal controls and 64 patients with glaucoma underwent 4.5 mm disc-centred and 6 mm macula-centred OCTA scans. The peripapillary nerve fibre layer plexus capillary density (NFLP-CD) and macular superficial vascular complex vessel density (SVC-VD) were measured using both a commercial algorithm (AngioAnalytics) and a custom algorithm (Center for Ophthalmic Optics & Lasers Angiography Reading Toolkit (COOL-ART)). The nerve fibre layer and ganglion cell complex thicknesses were measured on structural OCT.Results The overall peripapillary NFLP-CD and macular SVC-VD measured with the two algorithms were highly correlated but poorly agreed. Among the normal controls, the perfusion measurements made by both algorithms were significantly correlated with age. AngioAnalytics measurements were also correlated with signal strength index, while COOL-ART measurements were not. These covariates were adjusted. The diagnostic accuracy, measured as the area under the receiver operating characteristic curve for glaucoma detection, was not significantly different between algorithms, between structural and perfusion parameters and between the peripapillary and macular regions (All p>0.05). The macular SVC-VD in the 6 mm square had a significantly higher diagnostic accuracy than that of the central 3 mm square area (p=0.005).Conclusions AngioAnalytics and COOL-ART vessel density measurements are not interchangeable but potentially interconvertible. Age and signal strength are significant covariates that need to be considered. Both algorithms and both peripapillary and macular perfusion parameters have similarly good diagnostic accuracy comparable to structural OCT. A larger macular analytic area provides higher diagnostic accuracy.All data relevant to the study are included in the article or uploaded as supplementary information. None.