TY - JOUR
T1 - OCT Angiography for the Diagnosis of Glaucoma
T2 - A Report by the American Academy of Ophthalmology
AU - WuDunn, Darrell
AU - Takusagawa, Hana L.
AU - Sit, Arthur J.
AU - Rosdahl, Jullia A.
AU - Radhakrishnan, Sunita
AU - Hoguet, Ambika
AU - Han, Ying
AU - Chen, Teresa C.
N1 - Funding Information:
A.H.: Consultant – Aerie Pharmaceuticals, Inc. T.C.C.: research supported in part by Fidelity Charitable Fund.
Funding Information:
Funded without commercial support by the American Academy of Ophthalmology. The author(s) have made the following disclosure(s): D.W.: Financial support ? Allergan, Inc. Obtained funding: N/A; Study was performed as part of regular member volunteer duties at the American Academy of Ophthalmology. No additional funding was provided.
Publisher Copyright:
© 2021 American Academy of Ophthalmology
PY - 2021/8
Y1 - 2021/8
N2 - Purpose: To review the current published literature on the use of OCT angiography (OCTA) to help detect changes associated with the diagnosis of primary open-angle glaucoma. Methods: Searches of the peer-reviewed literature were conducted in March 2018, June 2018, April 2019, December 2019, and June 2020 in the PubMed and Cochrane Library databases. Abstracts of 459 articles were examined to exclude reviews and non-English articles. After inclusion and exclusion criteria were applied, 75 articles were selected and the panel methodologist rated them for strength of evidence. Three articles were rated level I and 57 articles were rated level II. The 15 level III articles were excluded. Results: OCT angiography can detect decreased capillary vessel density within the peripapillary nerve fiber layer (level II) and macula (level I and II) in patients with suspected glaucoma, preperimetric glaucoma, and perimetric glaucoma. The degree of vessel density loss correlates significantly with glaucoma severity both overall and topographically (level II) as well as longitudinally (level I). For differentiating glaucomatous from healthy eyes, some studies found that peripapillary and macular vessel density measurements by OCTA show a diagnostic ability (area under the receiver operating characteristic curve) that is comparable with structural OCT retinal nerve fiber and ganglion cell thickness measurements, whereas other studies found that structural OCT measurements perform better. Choroidal or deep-layer microvasculature dropout as measured by OCTA is also associated with glaucoma damage (level I and II). Lower peripapillary and macular vessel density and choroidal microvasculature dropout are associated with faster rates of disease progression (level I and II). Conclusions: Vessel density loss associated with glaucoma can be detected by OCTA. Peripapillary, macular, and choroidal vessel density parameters may complement visual field and structural OCT measurements in the diagnosis of glaucoma.
AB - Purpose: To review the current published literature on the use of OCT angiography (OCTA) to help detect changes associated with the diagnosis of primary open-angle glaucoma. Methods: Searches of the peer-reviewed literature were conducted in March 2018, June 2018, April 2019, December 2019, and June 2020 in the PubMed and Cochrane Library databases. Abstracts of 459 articles were examined to exclude reviews and non-English articles. After inclusion and exclusion criteria were applied, 75 articles were selected and the panel methodologist rated them for strength of evidence. Three articles were rated level I and 57 articles were rated level II. The 15 level III articles were excluded. Results: OCT angiography can detect decreased capillary vessel density within the peripapillary nerve fiber layer (level II) and macula (level I and II) in patients with suspected glaucoma, preperimetric glaucoma, and perimetric glaucoma. The degree of vessel density loss correlates significantly with glaucoma severity both overall and topographically (level II) as well as longitudinally (level I). For differentiating glaucomatous from healthy eyes, some studies found that peripapillary and macular vessel density measurements by OCTA show a diagnostic ability (area under the receiver operating characteristic curve) that is comparable with structural OCT retinal nerve fiber and ganglion cell thickness measurements, whereas other studies found that structural OCT measurements perform better. Choroidal or deep-layer microvasculature dropout as measured by OCTA is also associated with glaucoma damage (level I and II). Lower peripapillary and macular vessel density and choroidal microvasculature dropout are associated with faster rates of disease progression (level I and II). Conclusions: Vessel density loss associated with glaucoma can be detected by OCTA. Peripapillary, macular, and choroidal vessel density parameters may complement visual field and structural OCT measurements in the diagnosis of glaucoma.
KW - OCT angiography
KW - macular vessel density
KW - peripapillary vessel density
KW - primary open-angle glaucoma
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U2 - 10.1016/j.ophtha.2020.12.027
DO - 10.1016/j.ophtha.2020.12.027
M3 - Article
C2 - 33632585
AN - SCOPUS:85101210292
SN - 0161-6420
VL - 128
SP - 1222
EP - 1235
JO - Ophthalmology
JF - Ophthalmology
IS - 8
ER -