Peripapillary perfused capillary density in primary open-angle glaucoma across disease stage:an optical coherence tomography angiography study.
To assess peripapillary perfused capillary density (PCD) in primary open-angle glaucoma (POAG) across stage of disease.



In this observational, cross-sectional study, 60 eyes with varying stages of POAG and 24 control eyes were imaged on a spectral domain optical coherence tomography angiography system (AngioVue, Optovue, Fremont, California, USA) generating images centred on the optic nerve head. Major blood vessels were removed using custom automated software. PCD was calculated as a percentage as the ratio of pixels associated with perfused capillaries to the total number of pixels in the corresponding region-of-interest (ROI). Analysis of covariance was used to compare PCD among the subject groups and control for possible covariates. Area under the receiver operating characteristic curve (AROC) and sensitivity at 95% specificity were calculated to assess the capability of PCD to distinguish mild glaucoma from control. The Pearson's product-moment correlation coefficient was used to assess correlations between PCD and circumpapillary retinal nerve fibre layer thickness (cpRNFLT) and visual field mean deviation (MD).



PCD demonstrated a progressive stepwise decrease from control eyes throughout worsening POAG stage at all ROIs. PCD demonstrated AROC and sensitivity values comparable to cpRNFLT and visual field parameters and exhibited significant correlations with cpRNFLT and MD at all corresponding ROIs.



PCD displayed significant correlations with morphological and functional indices and exhibited diagnostic capabilities comparable to currently employed clinical variables. Our preliminary results suggest that PCD analysis may prove to be a useful tool in monitoring POAG across stage and identifying early POAG.
Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York, USA.|Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Lawrence S
LS
Geyman
Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York, USA.
Reena A
RA
Garg
Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York, USA.|Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Yanin
Y
Suwan
New York University, New York, New York, USA.
Vivek
V
Trivedi
Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York, USA.|Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Brian D
BD
Krawitz
Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York, USA.|Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Shelley
S
Mo
Department of Ophthalmology, State University of New York Downstate Medical Center, Brooklyn, New York, USA.
Alexander
A
Pinhas
Icahn School of Medicine at Mount Sinai, New York, New York, USA.|Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Apichat
A
Tantraworasin
Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York, USA.
Toco Y P
TYP
Chui
Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York, USA.
Robert
R
Ritch
Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York, USA.
Richard B
RB
Rosen
D000368:Aged; D019540:Area Under Curve; D002196:Capillaries / Q000473:pathology*; D000072226:Computed Tomography Angiography; D003430:Cross-Sectional Studies; D005260:Female; D005902:Glaucoma, Open-Angle / Q000145:classification / Q000175:diagnosis*; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D009412:Nerve Fibers / Q000473:pathology; D009898:Optic Disk / Q000098:blood supply*; D009901:Optic Nerve Diseases / Q000145:classification / Q000175:diagnosis*; D015203:Reproducibility of Results; D012165:Retinal Ganglion Cells / Q000473:pathology; D012171:Retinal Vessels / Q000473:pathology*; D041623:Tomography, Optical Coherence; D058609:Visual Field Tests; D014794:Visual Fields
Glaucoma; Imaging; Optic Nerve