Detection and Agreement of Event-based OCT and OCTA Analysis for Glaucoma Progression

Overview

Journal Eye (Lond)

Specialty Ophthalmology

Date 2023 Nov 11

PMID 37951976

Authors

Jo-Hsuan Wu

Sasan Moghimi

Takashi Nishida

Golnoush Mahmoudinezhad

Linda M Zangwill

Robert N Weinreb

Affiliations

Soon will be listed here.

Abstract

Objective: To examine event-based glaucoma progression using optical coherence tomography (OCT) and OCT angiography (OCTA).

Methods: In this retrospective study, glaucoma eyes with ≥2-year and 4-visits of OCT/OCTA imaging were included. Peripapillary capillary density (CD) and retinal nerve fibre layer thickness (RNFL) were obtained from 4.5 mm × 4.5 mm optic nerve head (ONH) scans. Event-based OCT/OCTA progression was defined as decreases in ONH measurements exceeding test-retest variability on ≥2 consecutive visits. Visual field (VF) progression was defined as significant VF mean deviation worsening rates on ≥2 consecutive visits. Inter-instrument agreement on progression detection was compared using kappa(κ) statistics.

Results: Among 147 eyes (89 participants), OCTA and OCT identified 33(22%) and 25(17%) progressors, respectively. They showed slight agreement (κ = 0.06), with 7(5%) eyes categorized as progressors by both. When incorporating both instruments, the rate of progressors identified increased to 34%. Similar agreement was observed in diagnosis- and severity-stratified analyses (κ < 0.10). Compared to progressors identified only by OCT, progressors identified only by OCTA tended to have thinner baseline RNFL and worse baseline VF. VF progression was identified in 11(7%) eyes. OCT and VF showed fair agreement (κ = 0.26), with 6(4%) eyes categorized as progressors by both. OCTA and VF showed slight agreement (κ = 0.08), with 4(3%) eyes categorized as progressors by both.

Conclusions: OCT and OCTA showed limited agreement on event-based progression detection, with OCT showing better agreement with VF. Both OCT and OCTA detected more progressors than VF. OCT and OCTA may provide valuable, yet different and complementary, information about glaucoma progression.

Citing Articles

Diagnostic Capability of OCTA-Derived Macular Biomarkers for Early to Moderate Primary Open Angle Glaucoma.

Verticchio Vercellin A, Harris A, Oddone F, Carnevale C, Siesky B, Arciero J J Clin Med. 2024; 13(14).

PMID: 39064230 PMC: 11278250. DOI: 10.3390/jcm13144190.

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