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      Wide-Field OCT Angiography Investigation of the Relationship Between Radial Peripapillary Capillary Plexus Density and Nerve Fiber Layer Thickness

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          Abstract

          Purpose

          To characterize the density and distribution of the radial peripapillary capillary plexus (RPCP) and its relationship with retinal nerve fiber layer (NFL) thickness in healthy subjects.

          Methods

          Using spectral-domain optical coherence tomography (OCT), split-spectrum amplitude decorrelation angiography algorithm and automated montaging, wide-field OCT angiography (OCTA) was used to measure the RPCP capillary density (CD) and NFL thickness. Polar sector-average CD and thickness maps were also created on each eye.

          Results

          Wide-field OCTA (8 × 8 mm) in 10 healthy eyes from 10 subjects demonstrated the distribution of the RPCP throughout the posterior pole. RPCP-CD decreases with distance from the disc, but along the arcuate nerve fiber bundles relatively dense (> half maximum density) RPCP extends more than 5 mm from the disc and includes regions superior to and inferior to the macula. The RPCP-CD and NFL thickness are highly correlated ( R 2 = 0.85, P < 0.001) and fit well with a nonlinear stacked-layer model. The model fit suggests that the RPCP is present when the NFL is thicker than 17.9 μm and reaches a ceiling area density of 84% and that the RPCP has an apparent volume density of 19% at the current instrument transverse resolution. This indicates that capillary overlap can be expected to occur when NFL thickness reaches 40 μm.

          Conclusions

          The wide distribution of dense overlapping RPCP suggests that wider (up to 8 mm vertical and 7 mm horizontal) OCTA scans may be better investigate capillary loss in the early stages of glaucoma or other optic neuropathies.

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          Most cited references33

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          Split-spectrum amplitude-decorrelation angiography with optical coherence tomography

          Amplitude decorrelation measurement is sensitive to transverse flow and immune to phase noise in comparison to Doppler and other phase-based approaches. However, the high axial resolution of OCT makes it very sensitive to the pulsatile bulk motion noise in the axial direction. To overcome this limitation, we developed split-spectrum amplitude-decorrelation angiography (SSADA) to improve the signal-to-noise ratio (SNR) of flow detection. The full OCT spectrum was split into several narrower bands. Inter-B-scan decorrelation was computed using the spectral bands separately and then averaged. The SSADA algorithm was tested on in vivo images of the human macula and optic nerve head. It significantly improved both SNR for flow detection and connectivity of microvascular network when compared to other amplitude-decorrelation algorithms.
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            Optical coherence tomography angiography of optic disc perfusion in glaucoma.

            To compare optic disc perfusion between normal subjects and subjects with glaucoma using optical coherence tomography (OCT) angiography and to detect optic disc perfusion changes in glaucoma.
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              • Record: found
              • Abstract: found
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              Optical Coherence Tomography Angiography of the Peripapillary Retina in Glaucoma.

              Vascular factors may have important roles in the pathophysiology of glaucoma. A practical method for the clinical evaluation of ocular perfusion is needed to improve glaucoma management.
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                Author and article information

                Journal
                Invest Ophthalmol Vis Sci
                Invest. Ophthalmol. Vis. Sci
                iovs
                iovs
                IOVS
                Investigative Ophthalmology & Visual Science
                The Association for Research in Vision and Ophthalmology
                0146-0404
                1552-5783
                October 2017
                : 58
                : 12
                : 5188-5194
                Affiliations
                [1]Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, United States
                Author notes
                Correspondence: David Huang, Casey Eye Institute, Oregon Health & Science University, 3375 S.W. Terwilliger Boulevard, Portland, OR 97239-4197, USA; davidhuang@ 123456alum.mit.edu .
                Article
                iovs-58-11-63 IOVS-17-22593R2
                10.1167/iovs.17-22593
                5637456
                29049718
                1cee40d3-5ec2-4a71-ab9e-e8f538cb8d54
                Copyright 2017 The Authors

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

                History
                : 11 July 2017
                : 8 September 2017
                Categories
                Multidisciplinary Ophthalmic Imaging

                optical coherence tomography angiography,radial peripapillary capillary plexus,nerve fiber layer thickness

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