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Detection and agreement of event-based OCT and OCTA analysis for glaucoma progression

Eye volume 38, pages 973–979 (2024)Cite this article

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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.

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Fig. 1: Venn diagrams demonstrating the counts and distribution of OCT, OCTA, and VF progressors.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Funding

Funding

This work is supported by National Institutes of Health/National Eye Institute Grants (R01EY034148, R01EY029058, R01EY011008, R01EY019869, R01EY027510, R01EY026574, R01EY018926, P30EY022589); University of California Tobacco Related Disease Research Program (T31IP1511), and an unrestricted grant from Research to Prevent Blindness (New York, NY). The sponsor or funding organization had no role in the design or conduct of this research.

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Author notes

  1. These authors contributed equally: Jo-Hsuan Wu, Sasan Moghimi.

Authors and Affiliations

  1. Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, CA, USA

    Jo-Hsuan Wu, Sasan Moghimi, Takashi Nishida, Golnoush Mahmoudinezhad, Linda M. Zangwill & Robert N. Weinreb

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  1. Jo-Hsuan Wu
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Contributions

JHW: study design, data analysis, results interpretation, production of tables and figures, and drafting and critical revision of the paper. SM: study design, results interpretation, drafting and critical revision of the paper, and providing research resources and fundings. TN: study design, data analysis, results interpretation, and critical revision of the paper. GM: results interpretation and critical revision of the paper. LZ: subject recruitment, study design, results interpretation, critical revision of the paper, and providing research resources and fundings. RNW: subject recruitment, results interpretation, critical revision of the paper, providing research resources and fundings, and taking full responsibility for the study as the guarantor.

Corresponding author

Correspondence to Robert N. Weinreb.

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Competing interests

SM reported grants from the National Eye Institute. TN is a consultant of Topcon. LZ reported grants from the National Eye Institute; grants from Heidelberg Engineering and nonfinancial support from Carl Zeiss Meditec, Optovue, Heidelberg Engineering, and Topcon. Consultant of Abbvie, AISight Health and Topcon and patents from Carl Zeiss Meditec. RNW is a consultant of Abbvie, Aerie Pharmaceuticals, Allergan, Amydis, Equinox, Eyenovia, Iantrek, IOPtic, Implandata, Nicox, and Topcon. RNW reported nonfinancial support from Heidelberg Engineering, Carl Zeiss Meditec, Konan Medical, Optovue, Centervue, and Topcon; grants from the National Eye Institute and National Institute of Minority Health Disparities, patents from Toromedes, Carl Zeiss Meditec to UCSD; all outside the submitted work. No other disclosures were reported.

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Wu, JH., Moghimi, S., Nishida, T. et al. Detection and agreement of event-based OCT and OCTA analysis for glaucoma progression. Eye 38, 973–979 (2024). https://doi.org/10.1038/s41433-023-02817-0

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