Glaucoma
Conditions
Keywords
Glaucoma, OCT, OCTA
Brief summary
Glaucoma is a chronic degenerative disease of the optic nerve. It is the second cause of blindness worldwide and a frequent cause of irreversible blindness. In 2020, epidemic health authorities have predicted about 80 million glaucoma patients. Glaucoma can be treated by topical treatment (eye drops), laser or surgery. A premature diagnosis of glaucoma is very important to prevent irreversible blindness. Pachymetry, Optical Coherence Tomography (OCT) and visual fields exams are fundamental for the development of the glaucoma diagnosis. The severity of glaucoma is defined with Hodapp-Parrish-Andersen visual field criteria. According to these criteria, glaucoma can be classified as early (with average visual field deviation, MD, of 0 to -6 dB), moderate (MD of -6 to -12 dB) and severe (MD worse than -12 dB). The progression of glaucoma is being identified by the visual fields tests, and also by the progression of alterations in the optic nerve head. The visual fields tests are long and difficult (30 minutes). It is therefore important to create additional tests and anticipate the diagnosis, in order to avoid the irreversibility of glaucoma.
Detailed description
The OCT Angiography (OCTA) is a non-invasive technology, marketed since 2014, that uses OCT with infrared light, with no radiation nor side effects, to evaluate within seconds the vascularization of the fundus, retina and optic nerve head, which may be useful for the glaucoma diagnosis. A recent meta-analysis has shown a decrease of the vascular density (DV) in glaucoma, so that OCTA may be useful in the advanced diagnosis of glaucoma. However, the VD values obtained were different depending on the device. In addition, no studies with the OCT Triton (Topcon®) device were considered in the analysis. The authors suggested the development of dedicated software, which would allow the evaluation of VD with different devices for a more independent and valid assessment. On the other hand, recent studies show that the diagnostic capacity of OCTA may be superior to that of OCT, and that OCTA may be more useful in determining the severity of glaucoma than OCT. It is therefore necessary to evaluate the additional diagnostic tests whether they are non-invasive and whether it allow us to give a faster diagnosis. This study is aimed at comparing the diagnostic utility of OCTA with standard complementary glaucoma examinations (OCT and CV).
Interventions
DIAGNOSTIC_TESTCase Group
The additional examination corresponds to an OCTA which is a non-invasive examination, without potential risks, without radiation, using infrared light.
DIAGNOSTIC_TESTControl Group
The additional examinations correspond to: * OCTA which is a non-invasive examination, without potential risks, without radiation, using infrared light. * OCT: non-invasive examination, without potential risks, without radiation, using infrared light. The patient must sit in front of a screen and a contact is taken without contact in about ten seconds. * Visual field
Sponsors
Fondation Hôpital Saint-Joseph
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
DIAGNOSTIC
Masking
NONE
Intervention model description
The study is a prospective multicentric and interventional trial that aims to compare the vascular density between patients with glaucoma and patients without glaucoma.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patient whose age ≥ 18 years * Patient consultant in the ophthalmology department of the Marie-Thérèse Health Center or the Polyclinique de la Baie * French speaking patient * Patient affiliated to a health insurance plan * Patient having given free, informed and express consent
Exclusion criteria
* Patient with another ophthalmological pathology or a history of ophthalmological pathology * Patient with a history of ophthalmic surgery except for uncomplicated cataract surgery * Patient under guardianship or curatorship * Patient deprived of liberty * Pregnant or lactating woman
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Vascular density between the 2 groups | Day1 | This outcome corresponds to percentage of vascularization of the optic papilla measured using OCTA. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Papilla supply according to severity of glaucoma | Day 1 | This outcome corresponds to the comparison of the percentages of vascular density as a function of the severity of glaucoma. |
| Difference of papilla vascularization depending on the regions of the papilla | Day 1 | This outcome corresponds to the comparison of the percentages of vascular density as a function of the regions of the papilla (intra-papillary, peripapillary, superior, inferior, nasal, temporal). 184/5000 corresponds to the comparison of the percentages of vascular density as a function of the regions of the papilla (intra-papillary, peripapillary, superior, inferior, nasal, temporal). |
| Vascularization of different regions of the papilla between case patients and control patients | Day 1 | This outcome corresponds to the comparison of the percentages of vascular density of the regions of the papilla between the case patients and the control patients. |
| Evaluation of the diagnostic performance of OCTA | Day 1 | This outcome corresponds to the comparison of the sensitivity and the specificity of OCTA compared to the additional examinations conventionally carried out within the framework of the diagnosis of glaucoma (OCT and visual fields) within the various regions of the vascular papilla between the case patients and the control patients. |
Countries
France
Outcome results
None listed