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. 2021 Jun 1;30(6):e276-e284.
doi: 10.1097/IJG.0000000000001860.

Superficial and Deep Macula Vessel Density in Healthy, Glaucoma Suspect, and Glaucoma Eyes

Nevin W El-Nimri  1 , Patricia Isabel C Manalastas  1 , Linda M Zangwill  1 , James A Proudfoot  1 , Christopher Bowd  1 , Huiyuan Hou  1 , Sasan Moghimi  1 , Rafaella C Penteado  1 , Jasmin Rezapour  1 , Eren Ekici  1   2 , Takuhei Shoji  1   3 , Elham Ghahari  1   4 , Adeleh Yarmohammadi  1 , Robert N Weinreb  1
Affiliations

Superficial and Deep Macula Vessel Density in Healthy, Glaucoma Suspect, and Glaucoma Eyes

Nevin W El-Nimri et al. J Glaucoma. .

Abstract

Precis: Macular superficial capillary plexus (SCP) vessel density is more informative than deep capillary plexus (DCP) vessel density for the detection of glaucoma.

Purpose: The purpose of this study was to characterize optical coherence tomography angiography macular SCP and projection-resolved DCP vessel densities and compare their diagnostic accuracies with ganglion cell complex (GCC) thickness in healthy, glaucoma suspect, and glaucoma eyes.

Materials and methods: Sixty-eight eyes of 44 healthy subjects, 26 eyes of 16 preperimetric glaucoma suspects, and 161 eyes of 124 glaucoma patients from the Diagnostics Innovations in Glaucoma Study with good quality high-density 6×6 mm2 macula optical coherence tomography angiography images were included. The diagnostic accuracy of SCP vessel density, projection-resolved DCP vessel density and GCC thickness were compared among groups.

Results: Mean whole image vessel density (wiVD; % of area occupied by vessels containing flowing blood) in the SCP layer was highest in healthy eyes (49.7%), followed by glaucoma suspect eyes (46.0%), and glaucoma eyes (40.9%) (P<0.001). Mean wiVD in the DCP layer was similar in healthy (50.6%), glaucoma suspect (47.3%), and glaucoma eyes (45.7%) (P=0.925). Diagnostic accuracy of both GCC thickness and SCP wiVD was significantly higher than DCP wiVD for classifying healthy and glaucoma eyes [adjusted area under the receiver operating characteristic curve (95% confidence interval): GCC=0.86 (0.72, 0.94), SCP=0.80 (0.66, 0.91) and DCP=0.44 (0.30, 0.57)] (P<0.001).

Conclusions: SCP vessel densities have better diagnostic accuracy for detecting glaucoma than DCP vessel densities. Although the diagnostic accuracy of the macula SCP is relatively modest, it is more informative than the DCP.

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Conflict of interest statement

Disclosure: P.I.C.M. was previously employed at Heidelberg Engineering, Alcon. L.M.Z. received financial support from National Eye Institute, Carl Zeiss Meditec Inc., Heidelberg Engineering GmbH, Optovue Inc., Topcon Medical Systems Inc. T.S. was a recipient at Alcon. R.N.W. received financial support from National Eye Institute, Heidelberg Engineering, Carl Zeiss Meditec, Konan, Optovue, Topcon, Centervue; is a consultant for Aerie Pharmaceuticals, Alcon, Allergan, Bausch & Lomb, Eyenovia. The remaining authors declare no conflict of interest.

Figures

Figure 1:
Figure 1:
Examples of OCT-A vessel density maps for superficial capillary plexus (SCP) and deep capillary plexus (DCP) high density 6x6 mm2 scans in healthy, suspect, and glaucoma eyes showing the inner and outer sectors (inner ring: inner diameter of 1 mm and outer diameter of 3 mm centered on the fovea. Outer ring: annular region with inner and outer diameters of 3 mm and 6 mm).
Figure 2:
Figure 2:
Comparison of mean macula superficial capillary plexus (SCP) and projection artifact-resolved deep capillary plexus (DCP) HD 6x6 mm2 vessel density measurements in healthy, suspect, and glaucoma eyes.
Figure 3:
Figure 3:
Age- and image scan quality index (SQI)-adjusted area under the receiver operating characteristic curves (AUC) comparing superficial capillary plexus (SCP) and projection artifact-resolved deep capillary plexus (DCP) HD 6 mm2 vessel density measurements in healthy, suspect, and glaucoma eyes
Figure 4:
Figure 4:
Examples of OCT-A images for superficial capillary plexus (SCP) and deep capillary plexus (DCP) HD 6x6 mm2 scans in healthy, suspect, and glaucoma eyes showing the presence of remaining projection artifacts in DCP slabs (arrows).
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References

    1. Halpern DL, Grosskreutz CL. Glaucomatous optic neuropathy: mechanisms of disease. Ophthalmol Clin North Am. 2002;15(1):61–68. - PubMed
    1. Flammer J, Orgül S, Costa VP, et al. The impact of ocular blood flow in glaucoma. Prog Retin Eye Res. 2002;21(4):359–393. - PubMed
    1. Weinreb RN, Aung T, Medeiros FA. The pathophysiology and treatment of glaucoma: a review. JAMA. 2014;311(18):1901–1911. - PMC - PubMed
    1. Curcio CA, Allen KA. Topography of ganglion cells in human retina. J Comp Neurol. 1990;300(1):5–25. - PubMed
    1. Hood DC, Raza AS, de Moraes CGV., Liebmann JM, Ritch R. Glaucomatous damage of the macula. Prog Retin Eye Res. 2013;32:1–21. - PMC - PubMed

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