Diagnostic ability of vessel density measured by spectral-domain optical coherence tomography angiography for glaucoma in patients with high myopia

Kwanghyun Lee,Chan Yun Kim,Wungrak Choi,Kyung Joo Maeng,Hyoung Won Bae,Heon Yang,Gong Je Seong,Sang Yeop Lee,Joo Yeon Kim

doi:10.1038/s41598-020-60051-0

Abstract

Although early glaucoma detection is important to prevent visual loss due to disease progression, its clinical diagnosis in highly myopic eyes is still difficult. Many studies using optical coherence tomography (OCT) angiography (OCTA) reported decreased vessel density (VD) in glaucomatous eyes compared to normal eyes. We evaluated the diagnostic ability of peripapillary VD and macular VD measured by OCTA, comparing them with conventional valuables such as peripapillary retinal nerve fibre layer (RNFL) thickness and macular ganglion cell-inner plexiform layer (GCIPL) thickness measured by OCT. We also calculated the average VD ratio (VDR) (average outer macular VD/average inner macular VD), superior VDR (superior outer macular VD/average inner macular VD), and inferior VDR (inferior outer macular VD/average inner macular VD). Totally, 169 eyes from 169 subjects were enrolled. Among OCTA measurements, the best diagnostic parameters were average VDR (AUROC: 0.852 and 0.909) and inferior VDR (AUROC: 0.820 and 0.941) in nonhighly and highly myopic eyes, respectively. Inferior VDR showed better diagnostic ability than most of the other OCT measurements including peripapillary RNFL thickness and macular GCIPL thickness in highly myopic eyes. Accordingly, OCTA measurements can be useful for diagnosing glaucoma in highly myopic eyes, especially when using calculated indices such as average VDR or inferior VDR.

Highlights

Early glaucoma detection is important to prevent visual loss due to disease progression, its clinical diagnosis in highly myopic eyes is still difficult
We determined the diagnostic ability of OCT angiography (OCTA) measurements and compared them with optical coherence tomography (OCT) measurements in nonhighly and highly myopic eyes
Suwan et al used 4.5 × 4.5-mm optic disc scan and reported a nonsignificant reduction in peripapillary vessel density (VD) in moderately to highly myopic eyes compared with a control group[16]

Summary

Introduction

Early glaucoma detection is important to prevent visual loss due to disease progression, its clinical diagnosis in highly myopic eyes is still difficult. We evaluated the diagnostic ability of peripapillary VD and macular VD measured by OCTA, comparing them with conventional valuables such as peripapillary retinal nerve fibre layer (RNFL) thickness and macular ganglion cell-inner plexiform layer (GCIPL) thickness measured by OCT. Inferior VDR showed better diagnostic ability than most of the other OCT measurements including peripapillary RNFL thickness and macular GCIPL thickness in highly myopic eyes. OCTA measurements can be useful for diagnosing glaucoma in highly myopic eyes, especially when using calculated indices such as average VDR or inferior VDR. To the best of our knowledge, few studies have compared the diagnostic ability of peripapillary VD and macular VD for glaucoma detection in highly myopic eyes. We compared the diagnostic ability of peripapillary VD and macular VD for glaucoma and compared it with that of peripapillary RNFL thickness and macular GCIPL thickness in both highly and nonhighly myopic eyes

Methods

Results

Conclusion