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      Visible Light Optical Coherence Tomography of Peripapillary Retinal Nerve Fiber Layer Reflectivity in Glaucoma

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          Abstract

          Purpose

          To evaluate the clinical utility of visible light optical coherence tomography (VIS-OCT) and to test whether VIS-OCT reflectivity and spectroscopy of peripapillary retinal nerve fiber layer (pRNFL) are correlated with severity of glaucoma, compared with standard-of-care OCT thickness measurements.

          Methods

          In total 54 eyes (20 normal, 17 suspect/preperimetric glaucoma [GS/PPG], 17 perimetric glaucoma [PG]) were successfully imaged with complete datasets. All the eyes were scanned by a custom-designed dual-channel device that simultaneously acquired VIS-OCT and near-infrared OCT (NIR-OCT) images. A 5 × 5 mm 2 scan was taken of the pRNFL. The pRNFL reflectivity was calculated for both channels and the spectroscopic marker was quantified by pVN, defined as the ratio of VIS-OCT to NIR-OCT pRNFL reflectivity. The results were compared with ophthalmic examinations and Zeiss Cirrus OCT.

          Results

          VIS-OCT pRNFL reflectivity significantly, sequentially decreased from normal to GS/PPG to PG, as did NIR-OCT pRNFL reflectivity. The pVN had the same decreasing trend among three groups. Normal and GS/PPG eyes were significantly different in VIS-OCT pRNFL reflectivity ( P = 0.002) and pVN ( P < 0.001), but were not in NIR-OCT pRNFL reflectivity ( P = 0.14), circumpapillary RNFL thickness ( P = 0.17), or macular ganglion cell layer and inner plexiform layer thickness ( P = 0.07) in a mixed linear regression model.

          Conclusions

          VIS-OCT pRNFL reflectivity and pVN better distinguished GS/PPG from normal eyes than Cirrus OCT thickness measurements.

          Translational Relevance

          VIS-OCT pRNFL reflectivity and pVN could be useful metrics in the early detection of glaucoma upon further longitudinal validation.

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          Most cited references38

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          The number of people with glaucoma worldwide in 2010 and 2020.

          To estimate the number of people with open angle (OAG) and angle closure glaucoma (ACG) in 2010 and 2020. A review of published data with use of prevalence models. Data from population based studies of age specific prevalence of OAG and ACG that satisfied standard definitions were used to construct prevalence models for OAG and ACG by age, sex, and ethnicity, weighting data proportional to sample size of each study. Models were combined with UN world population projections for 2010 and 2020 to derive the estimated number with glaucoma. There will be 60.5 million people with OAG and ACG in 2010, increasing to 79.6 million by 2020, and of these, 74% will have OAG. Women will comprise 55% of OAG, 70% of ACG, and 59% of all glaucoma in 2010. Asians will represent 47% of those with glaucoma and 87% of those with ACG. Bilateral blindness will be present in 4.5 million people with OAG and 3.9 million people with ACG in 2010, rising to 5.9 and 5.3 million people in 2020, respectively. Glaucoma is the second leading cause of blindness worldwide, disproportionately affecting women and Asians.
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            Optical coherence tomography.

            A technique called optical coherence tomography (OCT) has been developed for noninvasive cross-sectional imaging in biological systems. OCT uses low-coherence interferometry to produce a two-dimensional image of optical scattering from internal tissue microstructures in a way that is analogous to ultrasonic pulse-echo imaging. OCT has longitudinal and lateral spatial resolutions of a few micrometers and can detect reflected signals as small as approximately 10(-10) of the incident optical power. Tomographic imaging is demonstrated in vitro in the peripapillary area of the retina and in the coronary artery, two clinically relevant examples that are representative of transparent and turbid media, respectively.
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              Primary open-angle glaucoma.

              Primary open-angle glaucoma is a progressive optic neuropathy and, perhaps, the most common form of glaucoma. Because the disease is treatable, and because the visual impairment caused by glaucoma is irreversible, early detection is essential. Early diagnosis depends on examination of the optic disc, retinal nerve fibre layer, and visual field. New imaging and psychophysical tests can improve both detection and monitoring of the progression of the disease. Recently completed long-term clinical trials provide convincing evidence that lowering intraocular pressure prevents progression at both the early and late stages of the disease. The degree of protection is related to the degree to which intraocular pressure is lowered. Improvements in therapy consist of more effective and better-tolerated drugs to lower intraocular pressure, and more effective surgical procedures. New treatments to directly treat and protect the retinal ganglion cells that are damaged in glaucoma are also in development.
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                Author and article information

                Journal
                Transl Vis Sci Technol
                Transl Vis Sci Technol
                TVST
                Translational Vision Science & Technology
                The Association for Research in Vision and Ophthalmology
                2164-2591
                27 September 2022
                September 2022
                : 11
                : 9
                : 28
                Affiliations
                [1 ]Department of Medicine, Boston University School of Medicine, Boston Medical Center, Boston, MA, USA
                [2 ]Department of Epidemiology, School of Public Health, Johns Hopkins University, Baltimore, MD, USA
                [3 ]Department of Philosophy & Neuroscience, Boston University, Boston, USA
                [4 ]Department of Ophthalmology, Boston Medical Center, Boston, MA, USA
                [5 ]Department of Ophthalmology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
                [6 ]Department of Biomedical Engineering, Johns Hopkins University, Baltimore, USA
                Author notes
                [* ] Correspondence: Ji Yi, Department of Opthalmology and Biomedical Engineering, Johns Hopkins University, 400 N Broadway, Baltimore, MD 21231, USA. e-mail: jiyi@ 123456jhu.edu
                Article
                TVST-22-4625
                10.1167/tvst.11.9.28
                9526364
                36166221
                0625e55d-0f44-4b82-aeea-102d28b97a33
                Copyright 2022 The Authors

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : 19 August 2022
                : 23 March 2022
                Page count
                Pages: 12
                Categories
                Glaucoma
                Glaucoma

                visible light oct,peripapillary nerve fiber layer reflectivity,glaucoma,vnoct

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