Abstract：
OBJECTIVE: To measure low perfusion area (LPA) and focal perfusion loss (FPL) in the macula using optical coherence tomography (OCT) angiography (OCTA) for glaucoma.
METHODS: Prospective, cross-sectional \"case-control\" comparison study.
METHODS: A total of 60 patients with primary open-angle glaucoma (POAG) and 37 healthy participants were analyzed. AngioVue 6 × 6-mm high-definition (400 × 400 transverse pixels) macular OCTA scans were performed on one eye of each participant. Flow signal was calculated using the split-spectrum amplitude-decorrelation angiography algorithm. En face ganglion cell layer plexus (GCLP) and superficial vascular complex (SVC) images were generated. Using custom software, vessel density (VD) maps were obtained by computing the fraction of area occupied by flow pixels after low-pass filtering by local averaging 41 × 41 pixels. LPA was defined by local VD below 0.5 percentile over a contiguous area above 98.5 percentile of the healthy reference population. The FPL was the percentage VD loss (relative to normal mean) integrated over the LPA.
RESULTS: Among patients with POAG, 30 had perimetric and 30 had preperimetric glaucoma. The LPAGCLP-VD was 0.16±0.38 mm2 in normal and 5.78±6.30 mm2 in glaucoma subjects (P < .001). The FPLGCLP-VD was 0.20%±0.47% in normal and 7.52%±8.84% in glaucoma subjects (P < .001). The perimetric glaucoma diagnostic accuracy, measured by the area under the receiver operating curve, was 0.993 for LPAGCLP-VD and 0.990 for FPLGCLP-VD. The sensitivities were, respectively, 96.7% and 93.3% at 95% specificity. The LPAGCLP-VD and FPLGCLP-VD had good repeatability (0.957 and 0.952 by intraclass correlation coefficient). Diagnostic accuracy was better than GCLP VD (AROC 0.950, sensitivity 83.3%) and OCT ganglion cell complex (GCC) thickness (AROC 0.927, sensitivity 80.0%) and GCC focal loss volume (AROC 0.957, sensitivity 80.0%). The LPAGCLP-VD and FPLGCLP-VD correlated well with central VF mean deviations (Pearson r = -0.716 and -0.705 respectively, both P < .001).
CONCLUSIONS: Assessment of macular FPL using OCTA is useful in evaluating glaucomatous damage.
METHODS: Prospective, cross-sectional \"case-control\" comparison study.
METHODS: A total of 60 patients with primary open-angle glaucoma (POAG) and 37 healthy participants were analyzed. AngioVue 6 × 6-mm high-definition (400 × 400 transverse pixels) macular OCTA scans were performed on one eye of each participant. Flow signal was calculated using the split-spectrum amplitude-decorrelation angiography algorithm. En face ganglion cell layer plexus (GCLP) and superficial vascular complex (SVC) images were generated. Using custom software, vessel density (VD) maps were obtained by computing the fraction of area occupied by flow pixels after low-pass filtering by local averaging 41 × 41 pixels. LPA was defined by local VD below 0.5 percentile over a contiguous area above 98.5 percentile of the healthy reference population. The FPL was the percentage VD loss (relative to normal mean) integrated over the LPA.
RESULTS: Among patients with POAG, 30 had perimetric and 30 had preperimetric glaucoma. The LPAGCLP-VD was 0.16±0.38 mm2 in normal and 5.78±6.30 mm2 in glaucoma subjects (P < .001). The FPLGCLP-VD was 0.20%±0.47% in normal and 7.52%±8.84% in glaucoma subjects (P < .001). The perimetric glaucoma diagnostic accuracy, measured by the area under the receiver operating curve, was 0.993 for LPAGCLP-VD and 0.990 for FPLGCLP-VD. The sensitivities were, respectively, 96.7% and 93.3% at 95% specificity. The LPAGCLP-VD and FPLGCLP-VD had good repeatability (0.957 and 0.952 by intraclass correlation coefficient). Diagnostic accuracy was better than GCLP VD (AROC 0.950, sensitivity 83.3%) and OCT ganglion cell complex (GCC) thickness (AROC 0.927, sensitivity 80.0%) and GCC focal loss volume (AROC 0.957, sensitivity 80.0%). The LPAGCLP-VD and FPLGCLP-VD correlated well with central VF mean deviations (Pearson r = -0.716 and -0.705 respectively, both P < .001).
CONCLUSIONS: Assessment of macular FPL using OCTA is useful in evaluating glaucomatous damage.
摘要：
目的：使用OCT血管造影（OCTA）测量青光眼黄斑的低灌注面积（LPA）和局灶性灌注损失（FPL）。
方法：前瞻性，横断面“病例对照”比较研究。
方法：对60例原发性开角型青光眼（POAG）患者和37例正常参与者进行分析。对每个参与者的一只眼睛进行AngioVue6×6-mm高清（400×400横向像素）黄斑OCTA扫描。使用分裂频谱幅度去相关血管造影算法计算流量信号。生成面部神经节细胞层丛（GCLP）和浅表血管复合体（SVC）图像。使用自定义软件，血管密度（VD）图是通过计算低通滤波后通过局部平均41×41像素的流动像素所占的面积比例获得的。LPA定义为在高于98.5百分位的正常参考人群的连续区域内低于0.5百分位的局部VD。FPL是在LPA上整合的VD损失百分比(相对于正常平均值)。
结果：在POAG患者中，30人患有周边青光眼，30人患有周边青光眼。正常患者LPAGCLP-VD为0.16±0.38mm2,青光眼患者为5.78±6.30mm2(P<0.001)。正常患者的FPLGCLP-VD为0.20%±0.47%,青光眼患者为7.52%±8.84%(P<0.001)。眼周青光眼诊断的准确性，由接收器工作曲线下的面积测量，LPAGCLP-VD为0.993，FPLGCLP-VD为0.990。在95%特异性时，敏感性分别为96.7%和93.3%，分别。LPAGCLP-VD和FPLGCLP-VD具有良好的可重复性（组内相关系数为0.957和0.952）。诊断准确性优于GCLPVD（AROC0.950，灵敏度83.3%）和OCT神经节细胞复合体（GCC）厚度（AROC0.927，灵敏度80.0%），GCC局灶性损失量（AROC0.957，灵敏度80.0%）。LPAGCLP-VD和FPLGCLP-VD与中心VF平均偏差(皮尔逊的r分别为-0.716和-0.705,两者P<0.001)。
结论：使用OCTA评估黄斑局灶性灌注损失可用于评估青光眼损害。
方法：前瞻性，横断面“病例对照”比较研究。
方法：对60例原发性开角型青光眼（POAG）患者和37例正常参与者进行分析。对每个参与者的一只眼睛进行AngioVue6×6-mm高清（400×400横向像素）黄斑OCTA扫描。使用分裂频谱幅度去相关血管造影算法计算流量信号。生成面部神经节细胞层丛（GCLP）和浅表血管复合体（SVC）图像。使用自定义软件，血管密度（VD）图是通过计算低通滤波后通过局部平均41×41像素的流动像素所占的面积比例获得的。LPA定义为在高于98.5百分位的正常参考人群的连续区域内低于0.5百分位的局部VD。FPL是在LPA上整合的VD损失百分比(相对于正常平均值)。
结果：在POAG患者中，30人患有周边青光眼，30人患有周边青光眼。正常患者LPAGCLP-VD为0.16±0.38mm2,青光眼患者为5.78±6.30mm2(P<0.001)。正常患者的FPLGCLP-VD为0.20%±0.47%,青光眼患者为7.52%±8.84%(P<0.001)。眼周青光眼诊断的准确性，由接收器工作曲线下的面积测量，LPAGCLP-VD为0.993，FPLGCLP-VD为0.990。在95%特异性时，敏感性分别为96.7%和93.3%，分别。LPAGCLP-VD和FPLGCLP-VD具有良好的可重复性（组内相关系数为0.957和0.952）。诊断准确性优于GCLPVD（AROC0.950，灵敏度83.3%）和OCT神经节细胞复合体（GCC）厚度（AROC0.927，灵敏度80.0%），GCC局灶性损失量（AROC0.957，灵敏度80.0%）。LPAGCLP-VD和FPLGCLP-VD与中心VF平均偏差(皮尔逊的r分别为-0.716和-0.705,两者P<0.001)。
结论：使用OCTA评估黄斑局灶性灌注损失可用于评估青光眼损害。
