|
| Authors | Disease | No. of cases | OCTA device | Outcome | Limitations |
|
| Lee et al. [27] | Optic neuritis | 31 ON-affected eyes
31 fellow eyes
33 HC eyes | Cirrus | Reduction in parafoveal and peripapillary VD in the ON-affected eyes compared to fellow eyes | (i) Small sample size
(ii) Lack of subgroup analysis
(iii) A retrospective, cross-sectional study
(iv) Likelihood of quantification bias |
|
| Ulusoy et al. [28] | Optic neuritis | 20 patients with RRMS
24 HC | Optovue | Reduction in VD of the superficial plexus
(i) Superior hemisphere
(ii) Inferior hemisphere
(iii) The whole image
(iv) Parafoveal and perifoveal reduction in VD of the optic disc in the inferior and temporal sector | (i) Projection artifacts of OCTA images
(ii) Small study group |
|
| Spain et al. [29] | Optic neuritis MS | 68 eyes of 45 MS patients
55 eyes of 32 HC | Axsun technology | Reduction in ONH-FI, GCC thickness, and NFL thickness in MS patients without ON and MS patients with ON eyes | (i) Investigation of vascular risk factors using self-reports, and medication review
(ii) Lack of visual field testing
(iii) Lack of an automated focus in device
(iv) Motion artifacts of OCTA images |
|
| Lanzillo et al. [30] | Optic neuritis MS | 50 MS eyes
46 HC | Optovue | Reduction in VD in retina in MS patients with and without ON compared to healthy eye. | Small sample size |
|
| Wang et al. [29] | Optic neuritis MS | 52 MS eyes
21 HC eyes | Axsun technology | Reduction in ONH-FI of the MS with ON
No difference mean of parafoveal FIs among MS with ON, MS without ON, and HC eyes | Small sample size to the weak signal of some eyes |
|
| Fard et al. [31] | NAION Optic neuritis | 35 demyelinating ON eyes
33 eyes with NAION
81 HC eyes | Optovue | Thinner RNFL thickness in NAION than ON eyes reduction in peripapillary VD values in NAION and ON eyes compared with HC
No difference in all VD parameters between ON and NAION eyes | Small sample size clinical distinction between NAON and ON unable to determine cause-effect between VD and RNFL due to patients evaluation at the one-time point |
|
| Khader et al. [32] | Optic neuritis MS without optic neuritis | 10 ON eyes
10 MS-ON eyes
10 HC eyes | Cirrus | Reduction in the average thickness and all quadrants, notably, the temporal quadrant RNFL thickness and GCL thickness in all quadrants in ON
Lower superficial and deep VD index in ON and MS without ON | Motion and projection OCTA artifact loss of focus artifact and falsely reduced VD due to MS patients' ocular dysmetria OCTA cannot provide a quantitative evaluation of the flow velocity, vessel morphology, or changes in the vessel barrier |
|
| Lee et al. [27] | MS NMOSD | 23 MS patients with ON (36 eyes)
37 NMOSD patients white ON (47 eyes) | Cirrus | (i) Reduction of VD of the superficial radial capillary plexus and RPC in NMOSD
(ii) Association between RNFL and macular GCIPL thickness with peripapillary and parafoveal VD in the MS
(iii) Association between RNFL thickness with peripapillary and parafoveal VD in NMOSD
(iv) Associations between VF and VA and parafoveal and peripapillary VD in the MS group according to perfusion-visual function relationship
(v) Association between the functional parameters and peripapillary VD in the NMOSD group | (i) A retrospective, cross-sectional study
(ii) The likelihood of quantification bias |
|
| Rogaczewska et al. [33] | NMOSD MS | 13 NMOSD patients
40 MS patients | Optovue | (i) Reduction of RPC VD in the superior and inferior sectors in NMOSD
(ii) Reduction in the temporal sector of RPC in the MS group
(iii) Thinner RNFL in the inferior and temporal quadrants in NMOSD
(iv) No difference in the macular capillary plexuses and the GCC thickness between NMOSD and MS | Small group of NMOSD patients including only AQP4-IgG seropositive NMOSD patients.
Not generizable to seronegative NMOSD |
|
| Pierro et al. [20] | AION | 30 AION eyes
15 HC eyes | Topcon | Lower VD and vessel tortuosity values in AAION and NAION eyes
Reduction in RNFL in AAION and NAION eyes | (i) The possible artifacts affecting OCTA images
(ii) The possible effect of disc swelling on the detection of blood flow signal |
|
| Chen et al. [34] | AAION
NAION
ON
CON
TON
GON | 1 AAION
3 NAION
3 ON
1 CON
1 TON
1 GON | Optovue | (i) A decrease in peripapillary VD regardless of the etiology
(ii) Correlation between the peripapillary vessel loss with the areas of RNFL thinning on OCT | (i) Disc edema from acute AION obscures the analysis of the peripapillary capillaries
(ii) Focus on chronic optic neuropathies |
|
| Rougier et al. [35] | NAION
Papillitis
Papilledema | Eight eyes of 4 NAION
12 eyes of 6 papillitis
25 eyes of 13 papilledema | Cirrus | (i) NAION or papillitis: Disappearance or moderate pattern alteration in peripapillary capillary vessels
(ii) Papilledema, dilation, and tortuosity of the capillaries at the surface of the optic disc, with no peripapillary network pattern changes
(iii) NAION—no differences in VD and capillary flux index with unaffected fellow eyes
(iv) Papillitis with higher FI in inflammatory eyes with no differences in VPD | — |
|
| Song [26] | NAION | 41 eyes of 30 NAION
30 HC eyes | Optovue | (i) Reduction of VD in the peripapillary superficial retina and optic disc
(ii) Lower whole VD of the optic disc in the chronic NAION than acute NAION
(iii) Reduction of the VD peripapillary superficial retina and optic disc in unilateral involved eyes as compared to the fellow eyes | — |
|
| Sharma et al. [22] | NAION | 6 eyes of 5 acute NAION
19 HC eyes | Optovue | Global reduction of the mean peripapillary and the peripapillary choroid layer flow density | (i) Small sample size
(ii) The scarcity of NAION in Singapore (1.08/100 000) |
|
| Hata et al. [23] | NAION | 15 NAION eyes
19 HC eyes | Optovue | (i) Reduction in the VD of the peripapillary retina and inside the optic disc
(ii) Association between the severity of visual field defect and RNFL thinning with peripapillary VD but not with the optic disc VD
(iii) Reduction in RNFL and peripapillary VD, in the superior sectors, corresponds to the VF defect. | (i) Small number of patients with NAION
(ii) The inclusion of bilateral cases
(iii) The lack of information on blood pressure, which could affect the intraocular perfusion pressure
(iv) Evaluation in the atrophic phase of NAION
(v) OCTA artifacts |
|
| Balducci et al [21] | AION | 4 NA-AION patients
1 AAION patient | Optovue | Reduction of sectorial peripapillary VD and ONH and RPC VDs | OCTA images from a patient were excluded due to motion artifacts
Small sample size |
|
| Liu et al. [36] | NAION | 13 NAION patients
18 HC eyes | Optovue | Lower peripapillary VD
The parafoveal VD was not significantly different | Ethnic groups difference
Interpersonal changes in ONH blood supply |
|
| Higashiyama et al. [37] | ON | 7 ON patients
7 HC eyes | Optovue | Retinal thicknesses reduction prepapillary and in the macula retinal perfusions reduction prepapillary and in the macula | Retinal perfusion showed just after treatment
Detecting the slight decrease in retinal perfusion is difficult
Short time between examination and treatment |
|
| Aghdam et al. [17] | ONHD
NAION | 10 eyes with ONHD
10 eyes in acute NAION phase
10 HC eyes | Optovue | In ONH en face images, the difference in the VD measurements between the three groups In RPC en face image, the difference in the VD measurements between three groups except nasal prepapillary section | Groups are not matched for age OCTA artifacts |
|
| Mayes et al. [24] Ten17 | NAION | 10 eyes of 9 NAION patients | Optovue | Flow impairment in RPC compliant with the structural defect of RNFL and GCC and VF Flow disturbance in the PCC corresponded to structural defect of the RNFL, VF, and GCC | Error and bias which result from qualitative analysis that performed by an independent reader
Small sample size
No longitudinal follow-up |
|
| Ling et al. [25] | NAION | 21 eyes of NAION patients
19 HC eyes | Optovue | Increase nonperfused area of the optic disc
A relative correlation between the VF mean defect and the nonperfused area of the optic disc | Not age-matched
Excluded patients with acute-phase NAION that the optic discs exhibit constant edema
Optic disc abnormal morphologies were excluded |
|
| Augstburger [38] | NAION | 26 eyes of NAION patients
24 HC eyes | Optovue | Reduction in the RPC wiVD and the cpVD and correlation with RNFL thickness and visual acuity and mean deviation of the VF Capillary rarefaction in the SCP and DCP and correlation with VA | — |
|
| Wang et al. [39] | NAION | 37 NAION eyes with
30 uninvolved contralateral eyes
27 HC eyes | Optovue | Lower in RNFL thicknesses Lower GCC
Larger general loss volume values and sectoral loss volume
Lower superficial and deep VD Correlation between RNFL thickness and VF loss | OCTA is weak to show choroidal vessels structure
Measurement errors in density of choroidal vascularity |
|
| Ling [40] | NAION | 14 published studies | — | Reduction in the radial peripapillary capillary whole enface vessel density RPC inside disc vessel density RPC peripapillary vessel density
Peripapillary retinal NFL thickness and GCC thickness in macular zone | The consolidated estimates must be interpreted carefully as high heterogeneity is in this meta-analysis
Small sample size |
|
| Dhiman et al. [41] | NAION | 14 eyes of 14 NAION patients
12 HC eyes | Cirrus | Reduction in the mean total superficial retinal vessel in peripapillary area and perfusion density and the also superficial retinal perfusion | OCTA artifacts
Cross-sectional study which cannot show the post-NAION vascularity changes months after the episode |
|
| Rougier et al. [42] | NAION | 10 eyes of 10 NAION patients | Cirrus | A delayed ONH filling
Loss of the radial aspect in peripapillary network
Severe loss in peripapillary vascularization | Lack of quantified data |
|
| Fard et al. [43] | NAION
POAG | 31 chronic NAION
42 moderate and severe POAG
77 HC eyes | Optovue | Temporal and superior PCD were more affected
Higher PCD value in inferior sector in POAG eyes
Correlation between inferior and superior PCDs and also corresponding RNFL thicknesses | The PCD and RNFL are calculated with different instruments
Skeletonization of capillaries did not performed during processing of image Measuring of the vessel was not accurate Cross section design of study |
|
| Liu et al. [44] | NAION | 21 affected eyes
19 unaffected eyes
21 NAION patients | Optovue | Reduction in wRPC at enrollment
Reduction in wRPC in NAION eyes from the acute phase to the atrophy phase with severe reduction of sRPC | VF loss of threshold was not analyzed by detail prelaminar and laminar vasculature was not evaluated |
|
| Fard et al. [45] | NAION | 16 aNAION eyes
40 HC eyes | Optovue | Lower RPC densities and whole image in NAION
Lower RPC densities at cNAION than aAION
Lower hemi-superior and hemi-inferior RPC densities in cNAIO than aNAION
Total thickness of macular GCC is less in the cNAION group
No difference in total macular vessel density between groups
Deep macular vessel density was not affected in NAION groups and control | OCTA artifact
Initial involvement before visiting cannot be identified |
|
| Rebolleda et al. [46] | NAION | 6 NAION patients
10 HC eyes | Cirrus | Reduction in the PCD, vessel density, and PD at acute and atrophic phase
A significant reduction in PCD at the temporal area at the inner circle in vessel density and PD and GCIPL thinning after the 3 months | Lack of quantitative date OCTA artifacts |
|
| Contreras et al. [47] | NAION | All patients with NAION between April 1, 2004 to March 31, 2006 | Stratus OCT | Lower RNFL thickness in cNAION than aAION
The decrease in RNFL thickness of superior quadrant was significantly higher after 6 months
No correlation between VA, VF mean density, or RNFL thickness of the affected eyes | — |
|
| Fard et al. [48] | NAION Papilledema | 20 eyes with NAION
39 eyes with papilledema
22 HC eyes | Optovue | Vascular density is lower in the macular and parafoveal area in superficial and deep slabs in NAION eyes
VD values are similar in papilledema and control eyes
Superficial and deep macula vascular density is lower in the NAION than papilledema GCC thickness was similar in all groups | The cross-sectional design of study OCTA artifact |
|
| Bilen and Atilla, [49] | IIH | 38 eyes of 19 IIH
42 eyes of 21 HC | Optovue | Increase in inf. RNFL thickness
Decrease in mean peripapillary VD | IIH patients were a heterogeneous group in diagnostic time and treatment
Right and left eyes were evaluated separately, to diminish potential environmental and genetic factors which could have reduced the study's statistical power |
|
| Fard et al. [50] | Papilledema Pseudopapilledema | 41 eyes of 21 papilledema
27 eyes of 15 pseudopapilledema
44 eyes of 44 HC | Optovue | Greater RNFL thicknesses papilledema eyes
No differences in GCC thickness among all groups
Lower peripapillary vasculature values in papilledema and pseudopapilledema Differences in the peripapillary capillary density of papilledema eyes from healthy but lower in pseudopapilledema eyes than nasal sector peripapillary capillary density of inner retina and other whole image in pseudopapilledema | A difference in segmentation of irVD and trVD images for the control group may impact VD for the whole image analyses of custom software versus papilledema and pseudopapilledema in the ONH secondary to disc edema |
|
| Fard et al. [51] | NAION Papilledema Optic neuritis | 29 eyes with NAION
44 eyes with papilledema
8 eyes with acute optic neuritis
48 HC eyes | Optovue | In RPC and ONH images, reduction of the VD in each sextant, and the whole peripapillary VD values in papilledema and NAION eyes, with the latter being more severely affected.
No differences in VD between papilledema eyes and optic neuritis eyes Lower nasal and whole peripapillary sextant values in NAION than optic neuritis eyes for the ONH image | There was no prospective power calculation; however, when statistically insignificant results were obtained, the power was calculated retrospectively |
|
| Cennamo et al. [52] | ONHD | 19 eyes of 13 ONHD
24 eyes of 16 HC | Optovue | Lower GCC, RNFL, flow index, and VD parameters in ONHD patients
No visual field parameters difference between the two groups | OCTA images may have been affected by movement and blinking |
|
| Güler et al. [53] | Victims of viper bite | 31 victims of viper bite
31 HC eyes | Optovue | Increase in vascular densities and foveal flow areas
Decrease in flow areas and parafoveal vascular densities
Increase in retinal thickness in the parafoveal and foveal regions | Do not return patients for follow-up visits Ethically inappropriate to spend OCTA shots time on these patients that require treatment and close follow-up |
|
| Korkmaz et al. [54] | Iron deficiency anemia | 32 patients with IDA
30 HC eyes | Optovue | Reduction in capillary plexus density Reduction in density of SCP in the perifoveal area | Limitation of macular anatomy information in children
Not reported normal values of OCTA in children |
|
| Pellegrini et al. [55] | Vitamin B12 deficiency optic neuropathy | 1 patient | Topcon | Reduction in peripapillary and macular VD that correlated well with the areas of RNFL thinning | — |
|
| Abri Aghdam et al. [56] | NAION
CON
MION
TON | 32 patients with NAION
18 patients with CON
32 patients with MION
23 patients with TON
55 HC eyes | Optovue | Lower peripapillary RNFL thickness and RPC VD in all patients
Correlation between the RPC VD and peripapillary RNFL thickness in normal subjects and all study groups
Correlation between inside and outside disc RPC VD in the NAION and MION
No difference in terms of peripapillary and inside disc VD among the groups | Extracting results from the Optovue RTVue XR may cause bias, focusing mainly on patterns, correlations, and comparisons but not raw data.
To homogenize the study, patients with established optic atrophy were included in the study, but this was not ethical for CON patients |
|
| Montorio et al. [57] | Ocular blunt trauma | 18 eyes of 18 patients
18 HC eyes | Optovue | Reduction in GCC and RNFL thicknesses and VD of the RPC and SCP from 1 month to 3 months after the trauma
The initial decrease in the DCP VD after one month then increases until the sixth month to reach values same as those of the control group | Small sample size
Absence of a longer follow-up |
|
| Asanad, et al. [58] | LHON | Case report | Cirrus | Perfusion defects in the nasal and temporal peripapillary nerve fiber layer | — |
|
| Kousal et al. [59] | LHON | 12 eyes of 6 patients
6 HC eyes | Heidelberg | Decrease in the radial peripapillary microvascular network in all five affected eyes of three individuals | Due to the lack of available software, a quantitative assessment of capillary densities could not be performed.
Cannot explain artifacts and variability between different examinations because of the impossibility of performing the OCTA repeatedly |
|
| Balducci et al. [60] | LHON | 22 LHON patients | Optovue | Reduction of VD in the infratemporal and temporal sectors of LHON-e compared with controls and in the temporal sector compared with LHON-u
Reduction of VD in the supra and infratemporal and temporal sector of LHON-I compared with controls and LHON-u
Reduction of VD in all sector of LHON-ch compared with all groups | Many patients had both eyes studied, which can be a statistical confounder.
VD measurement was not done in the macular region
Genetic heterogeneity of the patients |
|
| Gaier et al. [61] | LHON | Case report | | More prominent telangiectatic vessels and demonstrated dilated peripapillary microvasculature temporally in the inner layers of the retina
Dense temporal capillaries within the papillomacular bundle | Case report |
|
| Matsuzaki et al. [62] | LHON | Case report | | Telangiectatic vessels and RPC defects in the temporal section
Relationship between RPC defective areas and RFT thinning with time | Case report |
|
| Takayama et al. [63] | LHON | Case report | | Parapapillary telangiectatic blood vessels | Case report |
|
| Yu et al. [64] | LHON | 28 eyes of 14 LHON patients
28 eyes of 14 HC | Optovue | In subacute and chronic LHON
Reduction in SCP and IRT
Reduction in RPC VD and thickness in the inferior temporal and temporal sectors
Lower RPC VD and thickness in the inferior temporal, superior temporal, temporal and nasal sectors than the subacute stage | There was genetic heterogeneity in the patients studied
Due to the rarity of LHON, the sample size was inevitably small |
|
