Comparison of Optical Coherence Tomography Angiography and Laser Speckle Flowgraphy for the Diagnosis of Normal-Tension Glaucoma.

Purpose: To compare optical coherence tomography angiography (OCT-A) and laser speckle flowgraphy (LSFG) for the diagnosis of normal-tension glaucoma (NTG).

Methods: Twenty-eight eyes of 28 patients with NTG and 25 eyes of 25 normal subjects matched for age, refractive errors, systemic blood pressure, and central corneal thickness were evaluated. OCT-A was used to measure whole image vessel density, inside disc vessel density, and peripapillary vessel density; using LSFG, mean blur rate (MBR) inside the whole optic nerve head (ONH) area (MBRA ), and MBR of the vessel area (MBRV ) and tissue area (MBRT ) inside the ONH, were determined. Receiver operating characteristic (ROC) curves and areas under the ROC (AUROC) were used to assess the diagnostic ability of each variable.

Results: The AUROC for OCT-A whole image vessel density (0.950) was significantly greater than that for OCT-A peripapillary vessel density (0.830) and for all LSFG parameters (MBRA  = 0.793, MBRV  = 0.601, and MBRT  = 0.61) ( P < 0.001). The AUROC for OCT-A inside disc vessel density (0.931) was significantly greater than that for all LSFG parameters ( P < 0.005).

Conclusions: OCT-A vessel density had a higher glaucoma diagnostic ability compared to all LSFG parameters in patients with NTG.