A Comparison Between Optical Coherence Tomography Angiography and Fluorescein Angiography for the Imaging of Type 1 Neovascularization

Inoue, Maiko; Jung, Jesse J.; Balaratnasingam, Chandrakumar; Dansingani, Kunal K.; Dhrami-Gavazi, Elona; Suzuki, Mihoko; Carlo, Talisa E de; Shahlaee, Abtin; Klufas, Michael A.; Maftouhi, A. El; Duker, Jay S.; Ho, Allen C.; Maftouhi, Maddalena Quaranta-El; Sarraf, David; Freund, K. Bailey

doi:10.1167/iovs.15-18900

Cited by 109 publications

(105 citation statements)

References 27 publications

(36 reference statements)

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“…Type 3 neovascularization is also referred to as retinal angiomatous proliferation. Studies have compared the detection of CNV using OCTA and traditional dye-based angiographic imaging, and SD-OCTA appeared to be inferior to FA for the detection the CNV (Costanzo, Miere et al 2016, Gong, Yu et al 2016, Inoue, Jung et al 2016); however, OCTA did prove useful in many of the cases. For the best visualization of CNV under the RPE, a longer wavelength of light is probably necessary, which should result in better penetration through the RPE, less sensitivity roll-off, and a better signal to noise ratio.…”

Section: Review Of Clinical Studies Utilizing Octamentioning

confidence: 99%

Optical coherence tomography angiography: A comprehensive review of current methods and clinical applications

Kashani

Chen

Gahm

et al. 2017

Progress in Retinal and Eye Research

768

561

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OCT has revolutionized the practice of ophthalmology over the past 10 to 20 years. Advances in OCT technology have allowed for the creation of novel OCT-based methods. OCT-Angiography (OCTA) is one such method that has rapidly gained clinical acceptance since it was approved by the FDA in late 2016. OCTA images are based on the variable backscattering of light from the vascular and neurosensory tissue in the retina. Since the intensity and phase of backscattered light from retinal tissue varies based on the intrinsic movement of the tissue (e.g. red blood cells are moving, but neurosensory tissue is static), OCTA images are essentially motion-contrast images. This motion-contrast imaging provides reliable, high resolution, and non-invasive images of the retinal vasculature in an efficient manner. In many cases, these images are approaching histology level resolution. This unprecedented resolution coupled with the simple, fast and non-invasive imaging platform have allowed a host of basic and clinical research applications. OCTA has been shown to demonstrate many important clinical findings including areas of macular telangiectasia, impaired perfusion, microaneurysms, capillary remodeling, some types of intraretinal fluid, and neovascularization among many others. More importantly, OCTA provides depth-resolved information that has never before been available. Correspondingly, OCTA has been used to evaluate a spectrum of retinal vascular diseases including diabetic retinopathy (DR), retinal venous occlusion (RVO), uveitis, retinal arterial occlusion, and age-related macular degeneration among others. In this review, we will discuss the methods used to create OCTA images, the practical applications of OCTA in light of invasive dye-imaging studies (e.g. fluorescein angiography) and review clinical studies demonstrating the utility of OCTA for research and clinical practice.

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Section: Review Of Clinical Studies Utilizing Octamentioning

confidence: 99%

Optical coherence tomography angiography: A comprehensive review of current methods and clinical applications

Kashani

Chen

Gahm

et al. 2017

Progress in Retinal and Eye Research

768

561

View full text Add to dashboard Cite

show abstract

“…15–20 Of these studies that evaluated active CNV, sensitivity and specificity was determined with en face OCTA only. 15–19 Detecting CNV with en face OCTA only is dependent on accurate segmentation, and errors may lead to false positives and false negatives. Cross-sectional images of the volumetric angiogram allow for more accurate depth discrimination of flow and is not dependent on segmentation.…”

Section: Introductionmentioning

confidence: 99%

Sensitivity and Specificity of OCT Angiography to Detect Choroidal Neovascularization

Faridi

Jia

Gao

et al. 2017

Ophthalmology Retina

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Purpose To determine the sensitivity and specificity of optical coherence tomography angiography (OCTA) in the detection of choroidal neovascularization (CNV) in age-related macular degeneration (AMD). Design Prospective case series. Subjects Prospective series of seventy-two eyes were studied, which included eyes with treatment-naive CNV due to AMD, non-neovascular AMD, and normal controls. Methods All eyes underwent OCTA with a spectral domain (SD) OCT (Optovue, Inc.). The 3D angiogram was segmented into separate en face views including the inner retinal angiogram, outer retinal angiogram, and choriocapillaris angiogram. Detection of abnormal flow in the outer retina served as candidate CNV with OCTA. Masked graders reviewed structural OCT alone, en face OCTA alone, and en face OCTA combined with cross-sectional OCTA for the presence of CNV. Main Outcome Measure The sensitivity and specificity of CNV detection compared to the gold standard of fluorescein angiography (FA) and OCT was determined for structural SD-OCT alone, en face OCTA alone, and with en face OCTA combined with cross-sectional OCTA. Results Of 32 eyes with CNV, both graders identified 26 true positives with en face OCTA alone, resulting in a sensitivity of 81.3%. Four of the 6 false negatives had large subretinal hemorrhage (SRH) and sensitivity improved to 94% for both graders if eyes with SRH were excluded. The addition of cross-sectional OCTA along with en face OCTA improved the sensitivity to 100% for both graders. Structural OCT alone also had a sensitivity of 100%. The specificity of en face OCTA alone was 92.5% for grader A and 97.5% for grader B. The specificity of structural OCT alone was 97.5% for grader A and 85% for grader B. Cross-sectional OCTA combined with en face OCTA had a specificity of 97.5% for grader A and 100% for grader B. Conclusions Sensitivity and specificity for CNV detection with en face OCTA combined with cross-sectional OCTA approaches that of the gold standard of FA with OCT, and it is better than en face OCTA alone. Structural OCT alone has excellent sensitivity for CNV detection. False positives from structural OCT can be mitigated with the addition of flow information with OCTA.

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“…18,20 Despite the evident benefits of OCTA, 21,22 it has not found its way into primary nAMD diagnosis, and treatment guidelines and FA/ICGA are still considered the gold standard for a comprehensive evaluation of lesion location and morphology. [11][12][13] Current efforts to fully explore and understand the capabilities of OCTA and to set the basis for future diagnostic and therapeutic criteria in nAMD include comparisons of FA and OCTA, [23][24][25] as well as ICGA and OCTA [26][27][28] with variable conclusions.…”

mentioning

confidence: 99%

Comparison of SD-Optical Coherence Tomography Angiography and Indocyanine Green Angiography in Type 1 and 2 Neovascular Age-related Macular Degeneration

Told

Sacu

Hecht

et al. 2018

Invest. Ophthalmol. Vis. Sci.

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A Comparison Between Optical Coherence Tomography Angiography and Fluorescein Angiography for the Imaging of Type 1 Neovascularization

Abstract: En face OCTA and structural OCT showed better detection of type 1 NV than either FA alone or en face OCTA alone. Combining en face OCTA and structural OCT information may therefore be a useful way to noninvasively diagnose and monitor the treatment of type 1 NV.

Cited by 109 publications

References 27 publications

Optical coherence tomography angiography: A comprehensive review of current methods and clinical applications

Optical coherence tomography angiography: A comprehensive review of current methods and clinical applications

Sensitivity and Specificity of OCT Angiography to Detect Choroidal Neovascularization

Comparison of SD-Optical Coherence Tomography Angiography and Indocyanine Green Angiography in Type 1 and 2 Neovascular Age-related Macular Degeneration

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