An overview of the clinical applications of optical coherence tomography angiography

Tan, Anna; Tan, Gavin Siew Wei; Denniston, Alastair K; Keane, Pearse A.; Ang, Marcus; Miléa, Dan; Chakravarthy, Usha; Cheung, Chui Ming Gemmy

doi:10.1038/eye.2017.181

Cited by 169 publications

(118 citation statements)

References 106 publications

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“…; Tan et al. ). The technique allows detailed study of flow within vascular structures of the eye and has the potential to improve diagnosis and monitoring of various retinal vascular abnormalities (Kashani et al.…”

Section: Methodsmentioning

confidence: 98%

“…; Tan et al. ). The research and clinical impact of OCTA are rapidly growing, but the technique has not been applied on patients with COPD (Kashani et al.…”

Section: Methodsmentioning

confidence: 98%

“…Evidence from earlier studies suggest that subfoveal choroidal thickness can provide indicative information regarding systemic cardiovascular health Ahn et al 2014;Altinkaynak et al 2014;Ahmad et al 2017). In addition to OCT, recently OCT angiography (OCTA) has been introduced with a superior view to look at the microvasculature (Kashani et al 2017;Tan et al 2018). The technique allows detailed study of flow within vascular structures of the eye and has the potential to improve diagnosis and monitoring of various retinal vascular abnormalities (Kashani et al 2017;Tan et al 2018).…”

Section: Optical Coherence Tomographymentioning

confidence: 99%

See 2 more Smart Citations

Looking into the eye of patients with chronic obstructive pulmonary disease: an opportunity for better microvascular profiling of these complex patients

Vaes

Spruit

Theunis

et al. 2018

Acta Ophthalmologica

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Chronic obstructive pulmonary disease (COPD) is a complex disease with many patients suffering from cardiovascular comorbidity. However, cardiovascular diseases remain often undiagnosed in COPD. Assessment of the retinal microvasculature can provide value in cardiovascular profiling of these patients. Retinal microvascular assessment carried out via a noninvasive eye exam represents an easy to use tool when examining patients with COPD. The purpose of this review was to provide an overview of studies assessing structural and functional changes in the retinal microvasculature of patients with COPD. Findings demonstrated that structural and functional microvascular changes were more common and severe in COPD patients as compared to non-COPD controls, although few retinal investigations have been performed in patients with COPD. As cardiovascular comorbidities are highly prevalent in COPD, we advocate more research to investigate the value of an eye exam for microvascular phenotyping of COPD patients.

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Section: Methodsmentioning

confidence: 98%

“…; Tan et al. ). The research and clinical impact of OCTA are rapidly growing, but the technique has not been applied on patients with COPD (Kashani et al.…”

Section: Methodsmentioning

confidence: 98%

Section: Optical Coherence Tomographymentioning

confidence: 99%

See 1 more Smart Citation

Looking into the eye of patients with chronic obstructive pulmonary disease: an opportunity for better microvascular profiling of these complex patients

Vaes

Spruit

Theunis

et al. 2018

Acta Ophthalmologica

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“…Clinically, OCTA has been used extensively to identify sub‐clinical vascular changes in all forms of retinal and choroidal diseases including diabetic retinopathy (DR), retinal vein occlusion (RVO), inherited retinal diseases and choroidal neovascularization in age‐related macular degeneration (AMD) . Currently, automated quantitative measurements of the capillary density and foveal avascular zone (FAZ) parameters can be generated to assess diseases progression and treatment response . However, the accuracy and reliability of these measurements are dependent on image quality.…”

Section: Introductionmentioning

confidence: 99%

“…5 Currently, automated quantitative measurements of the capillary density and foveal avascular zone (FAZ) parameters can be generated to assess diseases progression and treatment response. [6][7][8] However, the accuracy and reliability of these measurements are dependent on image quality. Therefore, image quality assessment is a critical aspect of initial OCTA evaluation.…”

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confidence: 99%

Clinical validation of the RTVue optical coherence tomography angiography image quality indicators

Ali

Sampson

Yong

et al. 2019

Clinical Exper Ophthalmology

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Importance All automated image quality indicators for en face optical coherence tomography angiography (OCTA) images require gold standard validation for determining optimum thresholds. Background A manual grading system (gold standard) for OCTA images was validated and compared to two automated image quality indicators: signal strength index (SSI) and scan quality index (SQI) generated by different software versions of the Optovue OCTA device. Design Retrospective cross‐sectional study. Participants A total of 52 eyes of 52 healthy individual and 77 eyes of 51 patients with retinal vascular diseases. Methods A total of 129 OCTA images of the superficial vascular plexus were graded manually by three independent examiners. Each image was assigned grades 1 to 4 (1‐2, unacceptable; 3‐4, acceptable) masked to the software‐generated quality indicators. Main Outcome Measures Inter‐grader agreement and comparison of the utility of SSI and SQI in discriminating between acceptable and unacceptable OCTA images. Results There was a substantial agreement between the three graders (κ = 0.63). Mean SSI and SQI was significantly different between acceptable and unacceptable images (P < .001). SQI outperformed SSI in separating acceptable from unacceptable images (areas under the receiver operating characteristic curve: 0.87 vs 0.80) and the optimum cut‐off was ≥7 for SQI and ≥70 for SSI for acceptable images. Up to 30% of images with quality indicators reaching the optimum SQI and SSI cut‐off thresholds still had unacceptable quality on manual grading. Unacceptable images were found in 33% and 66% of healthy and diseased eyes, respectively. Conclusions and Relevance SQI is closely related to manual grading but we caution reliance on the optimized threshold to determine image quality. SQI is superior to SSI in discriminating between acceptable and unacceptable images.

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Association of Optical Coherence Tomography and Optical Coherence Tomography Angiography Retinal Features With Visual Function in Older Adults

et al. 2022

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IMPORTANCEAlthough there is abundant evidence relating neuronal and vascular optical coherence tomography (OCT) and OCT angiography (OCTA) measures to retinal disease, data on the normative distribution of retinal features and their associations with visual function in a healthy, older, community-based population are sparse.OBJECTIVES To characterize the normative OCT and OCTA measures in older adults and describe their associations with visual function. DESIGN, SETTING, AND PARTICIPANTSThis was a cross-sectional, observational study conducted from May 17, 2017, to May 31, 2019. The study included a community-based sample. Participants in the Atherosclerosis Risk in Communities study from Jackson, Mississippi (all self-reported Black participants), and Washington County, Maryland (all self-reported White participants), were recruited in the Eye Determinants of Cognition study (EyeDOC). Data analyses were conducted from June 14, 2020, to May 31, 2021. MAIN OUTCOMES AND MEASURES Retinal measurements, including retinal nerve fiber layer (RNFL) thickness, macular ganglion cell complex (GCC) thickness, macular vessel density (VD) in the superficial capillary plexus (SCP) and deep capillary plexus (DCP), and foveal avascular zone (FAZ) area, were captured with spectral-domain OCT and OCTA. Visual function, including presenting distance vision, corrected distance vision, near visual acuity (VA), and contrast sensitivity (CS), was assessed. RESULTS A total of 759 participants (mean [SD] age, 80 [4.2] years; 480 female participants [63%]; 352 Black participants [46%]) were included in the study. Mean (SD) GCC thickness (89.2 [9.3] μm vs 92.3 [8.5] μm) and mean (SD) FAZ (0.36 [0.16] mm 2 vs 0.26 [0.12] mm 2 ) differed between Jackson and Washington County participants, respectively. Mean (SD) RNFL thickness and mean (SD) VD in SCP and DCP were greater for participants 80 years or younger than for participants older than 80 years (RNFL: Յ80 years, 93.2 [10.5] μm; >80 years, 91.1 [11.6] μm; VD SCP, Յ80 years, 44.3% [3.5%]; >80 years, 43.5% [3.8%]; VD DCP, Յ80 years, 44.7% [4.9%]; >80 years, 43.7% [4.8%]). Linear regression showed each 10-μm increment in RNFL thickness and GCC thickness was positively associated with 0.016 higher logCS among all participants (RNFL: 95% CI, 0.005-0.027; P = .004; GCC: 95% CI, 0.003-0.029; P = .02), with stronger associations among Jackson participants. The associations of VA and structural measures were found only in Jackson participants, with coefficients per 10-μm increment of 0.012 logMAR VA (RNFL: 95% CI, 0.000-0.023; P = .049) and 0.020 logMAR VA (GCC: 95% CI, 0.004-0.034; P = .04). CONCLUSIONS AND RELEVANCEIn this cross-sectional study, better CS was associated with greater RNFL thickness and GCC thickness, but no visual measures were associated with angiographic features overall. These findings suggest that clinical application of normative references for OCT-and OCTA-based measures should consider demographic and community features.

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An overview of the clinical applications of optical coherence tomography angiography

Cited by 169 publications

References 106 publications

Looking into the eye of patients with chronic obstructive pulmonary disease: an opportunity for better microvascular profiling of these complex patients

Looking into the eye of patients with chronic obstructive pulmonary disease: an opportunity for better microvascular profiling of these complex patients

Clinical validation of the RTVue optical coherence tomography angiography image quality indicators

Association of Optical Coherence Tomography and Optical Coherence Tomography Angiography Retinal Features With Visual Function in Older Adults

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