[OCT-angiography in glaucoma diagnosis - A multicenter case-control study]

We aimed to compare the vascular density (VD) obtained by OCT-angiography (OCTA) in glaucoma patients versus healthy controls.

We performed a multicenter prospective case-control study. All patients underwent a complete ophthalmologic examination with visual fields (VF), OCT, and OCTA. We used strict selection criteria. We used software to quantify the VD.

We included 91 patients, consisting of 37 controls and 54 cases, with 52.7% females and a mean age of 70.37±9.72 years. Mean peripapillary VD was of 81.0±10.5% in controls and 76.2±14% in glaucoma (P=0.01). The median macular VD was 41.33% [IQR 40.58-42.15] in controls versus 41.96% [IQR 40.12-43.06] in glaucoma, P=0.44, non-significant (except for the nasal sector). Mean deviations in VF, VD and OCT RNFL were statistically significantly different in glaucoma. The area under the curve (AUROC) was 0.16 for RNFL, 0.30 for MD and 0.30 for peripapillary VD.

This study showed a reduction in peripapillary VD in glaucoma. Macular VD was similar. There was good reproducibility between VD in both centers. The AUROC of OCTA was superior to that of OCT and VF, demonstrating a good diagnostic utility in glaucoma. Nevertheless, this AUROC was globally week, corroborating the fact that clinical examination is fundamental.