101. Discriminant Function of Optical Coherence Tomography Angiography to Determine Disease Severity in Glaucoma
- Author
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Abhijit Sinha Roy, Harsha L. Rao, Sujatha V Kadambi, Tin Aung, Rajesh Kumar, Neha Anegondi, Rachana Chandapura, and Suria Sudhakaran
- Subjects
Male ,Retinal Ganglion Cells ,0301 basic medicine ,Pathology ,medicine.medical_specialty ,genetic structures ,Fundus Oculi ,Optic Disk ,Nerve fiber layer ,Glaucoma ,Severity of Illness Index ,03 medical and health sciences ,Nerve Fibers ,0302 clinical medicine ,Discriminant function analysis ,Optical coherence tomography ,Ophthalmology ,Severity of illness ,medicine ,Humans ,Prospective Studies ,Fluorescein Angiography ,Prospective cohort study ,Intraocular Pressure ,medicine.diagnostic_test ,business.industry ,Discriminant Analysis ,Middle Aged ,Fluorescein angiography ,medicine.disease ,eye diseases ,Visual field ,Cross-Sectional Studies ,Early Diagnosis ,030104 developmental biology ,medicine.anatomical_structure ,ROC Curve ,030221 ophthalmology & optometry ,Female ,sense organs ,Visual Fields ,business ,Tomography, Optical Coherence ,Follow-Up Studies - Abstract
To determine the discriminant function of optical coherence tomography angiography (OCTA) by disease severity in glaucoma.In this prospective, observational cross-sectional study, all subjects underwent visual fields, retinal nerve fiber layer (RNFL) measurements, and OCTA imaging. Local fractal analysis was applied to OCTA images (radial peripapillary capillaries [RPC] layer). Vessel density en face and inside the disc and spacing between large and small vessels were quantified. Stepwise logistic regression was performed and a glaucoma severity score (range, 0-1: 0, normal; 1, severe glaucoma) was developed by using global and regional (superotemporal [ST], inferotemporal [IT], temporal, superonasal [SN], inferonasal, and nasal) vascular parameters. Glaucoma severity score was compared with visual field and RNFL indices.One hundred ninety-nine eyes (112 subjects) with glaucoma (28 eyes preperimetric; 83 early, 43 moderate, and 45 severe glaucoma) and 74 normal (54 subjects) eyes were enrolled. Preperimetric and glaucomatous eyes had significantly altered (P0.001) global vascular parameters as compared to normal; regionally, ST, then SN and IT sectors (in that order) showed more change in glaucomatous eyes. Vascular parameters showed better discriminant ability (area under the curve [AUC], sensitivity, and specificity of 0.70, 69.2%, and 72.9%, respectively) than structural parameters between normal and preperimetric glaucomatous eyes. Vascular parameters had comparable AUC (P0.05) to visual fields for perimetric glaucoma. Glaucoma severity score identified preperimetric glaucoma and early glaucoma better than did visual fields.Vascular parameters could be a useful adjunct tool to evaluate/diagnose glaucoma. Longitudinal studies are needed to determine their use in early detection and prognostication.
- Published
- 2016