title: Optical Coherence Tomography Angiography Analysis of Perfused Peripapillary Capillaries in Primary Open-Angle Glaucoma and Normal-Tension Glaucoma.
abstract: To compare perfused peripapillary capillary density in primary open-angle glaucoma (POAG), normal-tension glaucoma (NTG), and normal patients using optical coherence tomography angiography (OCT-A).
  
  
  
  A retrospective review of POAG, NTG, and normal patients imaged with OCT-A was performed. En face OCT angiograms identifying peripapillary vessels were obtained using a spectral-domain OCT system (Avanti RTVue-XR). A custom image analysis approach identified perfused peripapillary capillaries, quantified perfused capillary density (PCD), and generated color-coded PCD maps for 3.5- and 4.5-mm-diameter scans. We compared PCD values, PCD maps, standard automated perimetry (Humphrey visual field [HVF]) parameters, and OCT retinal nerve fiber layer (RNFL) thickness analyses across all groups.
  
  
  
  Forty POAG, 26 NTG, and 26 normal patients were included. Annular PCD in POAG (34.24 ± 6.76%) and NTG (37.75 ± 3.52%) patients was significantly decreased compared to normal patients (42.99 ± 1.81%) in 4.5-mm scans (P < 0.01 and P < 0.01, respectively). Similar trends and statistical significances were seen in 3.5-mm scans. Linear regression analysis resulted in moderate correlations between annular PCD values and other glaucomatous parameters. Pearson coefficients comparing annular PCD from 4.5-mm scans in POAG and NTG groups to HVF mean deviation, HVF pattern standard deviation, and average RNFL thickness all showed statistical significance (P < 0.05). Color maps showed that POAG and NTG patients had a reduction of perfused capillaries that progressed in size when comparing early, moderate, and severe glaucoma groups.
  
  
  
  Optical coherence tomography angiography can uniquely identify changes in peripapillary PCD in glaucoma patients. Optical coherence tomography angiography may offer insights into the pathophysiology of glaucomatous damage and risk factors for disease progression.
authors.affiliation: Department of Ophthalmology, The New York Eye and Ear Infirmary of Mount Sinai and Icahn School of Medicine at Mount Sinai, New York, New York, United States.
authors.forename: Nicole K
authors.initials: NK
authors.lastname: Scripsema
authors.affiliation: Department of Ophthalmology, The New York Eye and Ear Infirmary of Mount Sinai and Icahn School of Medicine at Mount Sinai, New York, New York, United States.
authors.forename: Patricia M
authors.initials: PM
authors.lastname: Garcia
authors.affiliation: Department of Ophthalmology, The New York Eye and Ear Infirmary of Mount Sinai and Icahn School of Medicine at Mount Sinai, New York, New York, United States 2Rutgers New Jersey Medical School, Newark, New Jersey, United States.
authors.forename: Richard D
authors.initials: RD
authors.lastname: Bavier
authors.affiliation: Department of Ophthalmology, The New York Eye and Ear Infirmary of Mount Sinai and Icahn School of Medicine at Mount Sinai, New York, New York, United States.
authors.forename: Toco Y P
authors.initials: TY
authors.lastname: Chui
authors.affiliation: Department of Ophthalmology, The New York Eye and Ear Infirmary of Mount Sinai and Icahn School of Medicine at Mount Sinai, New York, New York, United States.
authors.forename: Brian D
authors.initials: BD
authors.lastname: Krawitz
authors.affiliation: Department of Ophthalmology, The New York Eye and Ear Infirmary of Mount Sinai and Icahn School of Medicine at Mount Sinai, New York, New York, United States.
authors.forename: Shelley
authors.initials: S
authors.lastname: Mo
authors.affiliation: Department of Ophthalmology, The New York Eye and Ear Infirmary of Mount Sinai and Icahn School of Medicine at Mount Sinai, New York, New York, United States 3Department of Ophthalmology, SUNY Downstate Medical Center and SUNY Downstate College of Medicine, Brooklyn, New York, United States.
authors.forename: Steven A
authors.initials: SA
authors.lastname: Agemy
authors.affiliation: Department of Ophthalmology, The New York Eye and Ear Infirmary of Mount Sinai and Icahn School of Medicine at Mount Sinai, New York, New York, United States.
authors.forename: Luna
authors.initials: L
authors.lastname: Xu
authors.affiliation: Department of Ophthalmology, The New York Eye and Ear Infirmary of Mount Sinai and Icahn School of Medicine at Mount Sinai, New York, New York, United States.
authors.forename: Yijie B
authors.initials: YB
authors.lastname: Lin
authors.affiliation: Department of Ophthalmology, The New York Eye and Ear Infirmary of Mount Sinai and Icahn School of Medicine at Mount Sinai, New York, New York, United States.
authors.forename: Joseph F
authors.initials: JF
authors.lastname: Panarelli
authors.affiliation: Department of Ophthalmology, The New York Eye and Ear Infirmary of Mount Sinai and Icahn School of Medicine at Mount Sinai, New York, New York, United States.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Sidoti
authors.affiliation: Department of Ophthalmology, The New York Eye and Ear Infirmary of Mount Sinai and Icahn School of Medicine at Mount Sinai, New York, New York, United States.
authors.forename: James C
authors.initials: JC
authors.lastname: Tsai
authors.affiliation: Department of Ophthalmology, The New York Eye and Ear Infirmary of Mount Sinai and Icahn School of Medicine at Mount Sinai, New York, New York, United States.
authors.forename: Richard B
authors.initials: RB
authors.lastname: Rosen
mesh_terms: D000368:Aged; D002196:Capillaries / Q000473:pathology / Q000503:physiopathology; D005260:Female; D005451:Fluorescein Angiography / Q000379:methods*; D005654:Fundus Oculi; D005902:Glaucoma, Open-Angle; D006801:Humans; D007429:Intraocular Pressure; D057066:Low Tension Glaucoma / Q000175:diagnosis* / Q000503:physiopathology; D008297:Male; D008833:Microcirculation / Q000502:physiology*; D008875:Middle Aged; D009412:Nerve Fibers / Q000473:pathology*; D009898:Optic Disk / Q000473:pathology*; D010477:Perfusion; D015203:Reproducibility of Results; D012165:Retinal Ganglion Cells / Q000473:pathology*; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence / Q000379:methods*; D014794:Visual Fields