Although its causality is unknown, damage from glaucoma is highly interlinked to optic nerve and retinal blood flow. Octa work by takusagawa et al 53 x 53 takusagawa, h. Oct angiography octa has provided insights into the relationship between neuronal and vascular changes in glaucomatous eyes. Dynamic range of the peripapillary retinal vessel density. Octa also enables visualization of the choriocapillaris, but only in areas of parapapillary atrophy. Oct angiography nidek rs3000 advance of a 38yearold patient with a diagnosis of pigmentary glaucoma, with asymmetric damage, presenting a greater decrease in capillary density, optical coherence tomography parameters and defects of the visual field in left eye. Common artifacts include epiretinal membranes, tractional vitreomacular adhesions, eye movements and media opacities. The superimposition of the scans draws attention to the inferotemporal part of the macula. The retinal and choroidal vasculature can be the site of pathology in many ocular diseases, and dyebased angiography has been the gold standard diagnostic test for assessing vascular disorders such as choroidal neovascularization, retinal vascular occlusion, diabetic retinopathy, macular telangiectasia and central serous chorioretinopathy. Glaucoma is one of the main clinical areas where oct angiography is used. A practical method for the clinical evaluation of ocular perfusion is needed to improve glaucoma management. Oct angiography imaging is a relatively new technology that generates large amounts of clinical information.
Focused issue on oct angiography in glaucoma annals of. The advent of optical coherence tomography angiography octa provides a new opportunity to visualize the retinal vasculature in a. Research does oct angiography of macula play a role in. This is a nascent technology with a potential wide applicability for retinal vascular disease. Objective to detect peripapillary retinal perfusion in glaucomatous eyes compared with normal eyes using optical coherence tomography oct angiography. Oct is a well known and frequently used technology to image the posterior segment. Pdf optical coherence tomography angiography octa comprises different octbased technologies developed for noninvasive. Angioplex oct angiography allows visualization of both perfused vasculature and vascular abnormalities of the retina without the need of contrast. Optical coherence tomography angiography and glaucoma. Optical coherence tomography angiography in glaucoma ncbi. A team of researchers at mount sinai hospital new york, ny, along with collaborators at rutgers new jersey medical school newark, nj, is using optical coherence tomography angiography octa to look at the earliest stages of glaucoma and identify characteristic patterns of different forms of glaucoma based on their vascular patterns. To assess vascularity of the macular area in patients with glaucoma using optical coherence tomography angiography oct a and evaluate the role of its examination in early glaucoma diagnosis. Purpose to evaluate the macular capillary network density of superficial and deep retinal layers srldrl by sweptsource optical coherence tomography angiography octa in patients with primary open angle glaucoma poag and to compare the results with those of normal subjects.
Early macular angiography among patients with glaucoma, ocular. Mapping of b the sectoral and global ppvd, c circumpapillary retinal nerve fiber layer thickness, and d visual field vf sensitivity. At present, level 1 evidence of the technologys clinical applications doesnt exist. If conversion into glaucoma is observed with a combination of these tests, then standard glaucoma therapy will be initiated. Using the splitspectrum amplitudedecorrelation angiography ssada algorithm, flow in the optic disc can be quantified.
Optical coherence tomography angiography octa studies in primary open angle glaucoma have consistently demonstrated reduced microcirculation in the. Does oct angiography of macula play a role in glaucoma diagnostics. The advent of optical coherence tomography angiography oct a provides a new opportunity to visualize the retinal vasculature in a noninvasive and dyefree manner which may help identify vascular abnormalities in glaucoma. Systematic interpretation of oct angiography images youtube. Spectraldomain optical coherence tomography sd oct has grown in importance in diagnosing glaucoma, allowing clinicians to assess structural changes in the optic disc and macula 6 10. Fourierdomain optical coherence tomography fd oct, the technology that already provides unprecedented views of the eyes inner microstructures, is wowing ophthalmic researchers againthis time as a fast, noninvasive, 3d alternative to fluorescein angiography. One of the greatest benefits of oct angiography octa is that it allows users to observe, measure, and monitor capillaries located in the retina and surrounding. Method in this prospective study, 24 eyes of 24 normal individuals and 24. These apsbased scan patterns are automatically matched to each eyes unique anatomic landmarks and to the characteristics. Optical coherence tomography angiography octa, adapted from traditional optical coherence tomography oct, is a robust noncontact, noninvasive imaging system that provides reproducible, 3dimensional, highresolution volumetric and quantitative data of the retinal layers including vascular networks in retina, optic nerve, and choroid. Projectionresolved optical coherence tomography angiography of macular retinal circulation in glaucoma. Glaucoma is recognized as a multifactorial disease. Quinn, md, discusses the detection of glaucoma using sd oct in a highrisk retailbased population, as part of the equality study.
Optical coherence tomography angiography octa is a new modality in ocular imaging which provides noninvasive assessment and measurement of the vascular structures in the retina and optic nerve head. Optical coherence tomography angiography octa is a new, noninvasive imaging technique that generates volumetric angiography images in a matter of seconds. Optical coherence tomography oct angiography octa is a recently developed technique that provides a quantitative assessment of the microcirculation of the retina and choroid in a fast, noninvasive way. Whats new in optical coherence tomography angiography for. Importance vascular factors may have important roles in the pathophysiology of glaucoma. A, measurement of the peripapillary retinal vessel density ppvd in en face oct angiography octa images, excluding largevessel signals. Understanding optical coherence tomography angiography in. Color photo 1 and redfree filter image 2 showing no obvious hemorrhage. Glaucoma is the second leading cause of blindness worldwide, affecting more than 60. Optical coherence tomography angiography octa comprises different oct based technologies developed for noninvasive assessment and. Optical coherence tomography angiography in glaucoma. Enter optical coherence tomography angiography oct optical coherence tomography angiography oct a may be one of the greatest breakthroughs in ophthalmology in a decade. Tutorials spectralis oct the modular imaging platform. Octa uses the motion of red blood cells as an intrinsic contrast agent to create reproducible images of microvascular networks rapidly and noninvasively.
Results in normal discs, a dense microvascular network was visible on oct angiography. To evaluate early macular circulation in openangle glaucoma oag, normaltension glaucoma ntg, ocular hypertension oht, and healthy subjects via optical coherence tomography angiography octa. Sweptsource oct angiography imaging of the macular. The research could lead doctors to diagnose glaucoma. Optical coherence tomography angiography octa comprises different octbased technologies developed for noninvasive assessment and measurement of optic nerve head and retinal perfusion. We measured the vessel density vd of the optic disc in odd using optical coherence tomography angiography and compared it with a normal population. Background compared with current imaging methods, the diagnostic performance and the advantages and limitations of optical coherence tomography angiography octa remain unclear. This network was visibly attenuated in subjects with glaucoma. This technique provides useful information in glaucoma, such as quantitative assessment of vessel density. Reproducibility of optical coherence tomography angiography macular and optic nerve head vascular density in glaucoma and healthy. Further, recent studies have shown that peripapillary vessel density vd and macular vd, as measured by oct angiography octa, in glaucoma eyes are.
Ocular microcirculation measurement with laser speckle. Octangiography passing through the choriocapillaris shows branching vascular networks in the upper part of the macula 5,6. Background optic disc drusen odd can cause retinal nerve fibre layer rnfl defects with progressive visual field vf loss. Oct angiography is shown to detect earlystage glaucoma. The focal capillary dropout arrows can be visualized more clearly in the nerve fiber layer plexus slab than on the ganglion cell layer plexus and allplexus retinal angiograms. While oct technology has been widely used in clinical practice for more than two decades oct angiography reached clinical applicability only less. Optical coherence tomography angiography of optic disc. Diagnostic ability of vessel density measured by spectral. Promise of optical coherence tomography angiography in. In contrast to medical retinal application, where qualitative image analysis and semiquantitative measurements are frequently satisfactory for clinical decisionmaking, in glaucoma the exact quantitative measurements provide the useful information.
Images can be obtained without the injection of dyes into the body, thereby eliminating risk of morbidity or mortality. Diagnostic performance of optical coherence tomography. Quantitative oct angiography may have value in future studies to determine its potential usefulness in glaucoma evaluation. Oct angiography of the peripapillary retina in primary openangle. Measurement floors and dynamic ranges of oct and oct angiography in glaucoma. Oct angiography for glaucoma o ne of the greatest benefits of oct angiography octa is that it allows users to observe, measure, and monitor capillaries located in the retina and surrounding the optic nerve. Spectralis glaucoma module premium edition heidelberg. It has the potential to shed light into the pathophysiology of glaucoma and may very soon change clinical practices in ophthalmology. Diagram for b the en face octa image indicates the same sectors as those. Our patient is currently scheduled for followups every 6 months with repeat oct angiography, oct rnflgcc, and hvf 242. The promise of optical coherence tomography angiography in. Representative optical coherence tomography angiography octa a and laser speckle flowgraphy f images of the same glaucoma patient. Optical coherence tomography angiography to better. Despite it being a novel technique, several publications have already been done in the glaucoma field.
Optical coherence tomography angiography octa is based on the detection and analysis of the reflection behaviour of motion in a. It is therefore important to define a consistent method of assessing oct angiography. Optical coherence tomography angiography octa is a relatively new, noninvasive, dyefree imaging modality that provides a qualitative and quantitative assessment of the vasculature in the retina and optic nerve head. In fact, a recent study looking at sdoct imaging for glaucoma showed artifacts to be present anywhere from 15% to 36% of the time. Optical coherence tomography angiography octa has emerged as a promising new technology well positioned to become the first clinically suitable test of optic nerve perfusion. Optical coherence tomography angiography analysis of macular. A retrospective crosssectional study was conducted. Optical coherence tomography angiography oct angiography applied for glaucoma research and glaucoma patient management is one of the highest ranked and most rapidly developing area of ophthalmology. En face optical coherence angiography images and the corresponding enface oct images of four layers of the disk and peripapillary retina in severe glaucoma. Pdf optical coherence tomography angiography in glaucoma. Optical coherence tomography angiography octa is a relatively new, non invasive, dyefree. Early macular angiography among patients with glaucoma. A glaucomatous eye imaged by the angiovue oct angiography system optovue using the 4.