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      Relationship between optical coherence tomography sector peripapillary angioflow-density and Octopus visual field cluster mean defect values

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      PLoS ONE
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          Abstract

          Purpose

          To compare the relationship of Octopus perimeter cluster mean-defect (cluster MD) values with the spatially corresponding optical coherence tomography (OCT) sector peripapillary angioflow vessel-density (PAFD) and sector retinal nerve fiber layer thickness (RNFLT) values.

          Methods

          High quality PAFD and RNFLT images acquired on the same day with the Angiovue/RTVue-XR Avanti OCT (Optovue Inc., Fremont, USA) on 1 eye of 27 stable early-to-moderate glaucoma, 22 medically controlled ocular hypertensive and 13 healthy participants were analyzed. Octopus G2 normal visual field test was made within 3 months from the imaging.

          Results

          Total peripapillary PAFD and RNFLT showed similar strong positive correlation with global mean sensitivity (r-values: 0.6710 and 0.6088, P<0.0001), and similar (P = 0.9614) strong negative correlation (r-values: -0.4462 and -0.4412, P≤0.004) with global MD. Both inferotemporal and superotemporal sector PAFD were significantly (≤0.039) lower in glaucoma than in the other groups. No significant difference between the corresponding inferotemporal and superotemporal parameters was seen. The coefficient of determination (R 2) calculated for the relationship between inferotemporal sector PAFD and superotemporal cluster MD (0.5141, P<0.0001) was significantly greater than that between inferotemporal sector RNFLT and superotemporal cluster MD (0.2546, P = 0.0001). The R 2 values calculated for the relationships between superotemporal sector PAFD and RNFLT, and inferotemporal cluster MD were similar (0.3747 and 0.4037, respectively, P<0.0001).

          Conclusion

          In the current population the relationship between inferotemporal sector PAFD and superotemporal cluster MD was strong. It was stronger than that between inferotemporal sector RNFLT and superotemporal cluster MD. Further investigations are necessary to clarify if our results are valid for other populations and can be usefully applied for glaucoma research.

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          Most cited references27

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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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            The impact of ocular blood flow in glaucoma.

            Two principal theories for the pathogenesis of glaucomatous optic neuropathy (GON) have been described--a mechanical and a vascular theory. Both have been defended by various research groups over the past 150 years. According to the mechanical theory, increased intraocular pressure (IOP) causes stretching of the laminar beams and damage to retinal ganglion cell axons. The vascular theory of glaucoma considers GON as a consequence of insufficient blood supply due to either increased IOP or other risk factors reducing ocular blood flow (OBF). A number of conditions such as congenital glaucoma, angle-closure glaucoma or secondary glaucomas clearly show that increased IOP is sufficient to lead to GON. However, a number of observations such as the existence of normal-tension glaucoma cannot be satisfactorily explained by a pressure theory alone. Indeed, the vast majority of published studies dealing with blood flow report a reduced ocular perfusion in glaucoma patients compared with normal subjects. The fact that the reduction of OBF often precedes the damage and blood flow can also be reduced in other parts of the body of glaucoma patients, indicate that the hemodynamic alterations may at least partially be primary. The major cause of this reduction is not atherosclerosis, but rather a vascular dysregulation, leading to both low perfusion pressure and insufficient autoregulation. This in turn may lead to unstable ocular perfusion and thereby to ischemia and reperfusion damage. This review discusses the potential role of OBF in glaucoma and how a disturbance of OBF could increase the optic nerve's sensitivity to IOP.
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              • Record: found
              • Abstract: found
              • Article: not found

              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

                Contributors
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                2 February 2017
                2017
                : 12
                : 2
                : e0171541
                Affiliations
                [001]Department of Ophthalmology, Semmelweis University, Budapest, Hungary
                Roskamp Institute, UNITED STATES
                Author notes

                Competing Interests: Gabor Hollo is an unpaid consultant of Optovue and Zeiss. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

                • Conceptualization: GH.

                • Data curation: GH.

                • Formal analysis: GH.

                • Investigation: GH.

                • Methodology: GH.

                • Project administration: GH.

                • Resources: GH.

                • Supervision: GH.

                • Validation: GH.

                • Visualization: GH.

                • Writing – review & editing: GH.

                Author information
                http://orcid.org/0000-0002-0904-4849
                Article
                PONE-D-16-17163
                10.1371/journal.pone.0171541
                5289610
                28152106
                225d5087-f8b7-4b98-93dd-5b4f79964e20
                © 2017 Gábor Holló

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 28 April 2016
                : 17 January 2017
                Page count
                Figures: 3, Tables: 4, Pages: 12
                Funding
                The author received no specific funding for this work.
                Categories
                Research Article
                Medicine and Health Sciences
                Ophthalmology
                Eye Diseases
                Glaucoma
                Biology and Life Sciences
                Anatomy
                Head
                Eyes
                Medicine and Health Sciences
                Anatomy
                Head
                Eyes
                Biology and Life Sciences
                Anatomy
                Ocular System
                Eyes
                Medicine and Health Sciences
                Anatomy
                Ocular System
                Eyes
                Biology and Life Sciences
                Cell Biology
                Cellular Types
                Animal Cells
                Neurons
                Nerve Fibers
                Biology and Life Sciences
                Neuroscience
                Cellular Neuroscience
                Neurons
                Nerve Fibers
                Medicine and Health Sciences
                Diagnostic Medicine
                Diagnostic Radiology
                Tomography
                Research and Analysis Methods
                Imaging Techniques
                Diagnostic Radiology
                Tomography
                Medicine and Health Sciences
                Radiology and Imaging
                Diagnostic Radiology
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                Medicine and Health Sciences
                Cardiovascular Medicine
                Cardiovascular Imaging
                Angiography
                Medicine and Health Sciences
                Diagnostic Medicine
                Diagnostic Radiology
                Cardiovascular Imaging
                Angiography
                Research and Analysis Methods
                Imaging Techniques
                Diagnostic Radiology
                Cardiovascular Imaging
                Angiography
                Medicine and Health Sciences
                Radiology and Imaging
                Diagnostic Radiology
                Cardiovascular Imaging
                Angiography
                Biology and Life Sciences
                Anatomy
                Ocular System
                Optic Nerve
                Medicine and Health Sciences
                Anatomy
                Ocular System
                Optic Nerve
                Medicine and Health Sciences
                Ophthalmology
                Biology and Life Sciences
                Anatomy
                Ocular System
                Ocular Anatomy
                Retina
                Medicine and Health Sciences
                Anatomy
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                Ocular Anatomy
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