Comparison of Automated versus Manually Modified OCT Angiography En Face Slabs for Detection of Choroidal Neovascularization

Siggel, Robert; Spital, Christel; Lentzsch, Anna; Liakopoulos, Sandra

doi:10.1016/j.oret.2019.11.018

Cited by 9 publications

(11 citation statements)

References 22 publications

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“…The lack of detection of low flow rates still represents a major limitation in OCT-A technology [49]; however, the continuous evolution of new algorithms will soon allow us to solve this problem. The wide variability in flow-sensibility among different types of OCT-A devices should be kept in mind when evaluating patients in everyday clinical practice [50].…”

Section: Discussionmentioning

confidence: 99%

Biomarkers in Early Response to Brolucizumab on Pigment Epithelium Detachment Associated with Exudative Age-Related Macular Degeneration

Rispoli

Eandi

Antonio³

et al. 2021

Biomedicines

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Background: The purpose of this study was to describe early changes in the morphology of pigment epithelium detachments (PED) after an intravitreal injection of Brolucizumab into eyes with macular neovascularization secondary to exudative age-related macular degeneration (e-AMD). Method: We included twelve eyes of 12 patients with PED secondary to e-AMD which were not responding to prior anti-VEGF treatments. An ophthalmic examination and an assessment of PED-horizontal maximal diameter (PED-HMD), PED-maximum high (PED-MH) and macular neovascularization (MNV) flow area (MNV-FA) by the means of structural optical coherence tomography (OCT) and OCT Angiography (OCT-A) were performed at baseline, as well as 1, 7, 14 and 30 days after the injection. Results: The mean age of the population of study was 78.4 (SD ± 4.8). The mean number of previous Ranibizumab or Aflibercept injections was 13 (SD ± 8). At the last follow-up visit, the PED-HMD did not significantly change (p = 0.16; F(DF:1.94, 20,85) = 1.9), the PED-MH showed a significant reduction [p = 0.01; F(DF:1.31, 14.13) = 6.84.] and the MNV-FA did not significantly differ (p = 0.1; F(1.97, 21.67) = 2.54) from baseline. No signs of ocular inflammation were observed during follow-up. Conclusions: A single Brolucizumab injection was able to determine the short-term effects on PEDs’ anatomical features of eyes with an unresponsive e-AMD.

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Section: Discussionmentioning

confidence: 99%

Biomarkers in Early Response to Brolucizumab on Pigment Epithelium Detachment Associated with Exudative Age-Related Macular Degeneration

Rispoli

Eandi

Antonio³

et al. 2021

Biomedicines

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“…Because the morphologic changes in the retina often lead to incorrect segmentation impeding MNV depiction, all B scans depicting the MNV were checked and the segmentation lines were manually adjusted in each B scan whenever necessary. 14 The images were exported to ImageJ (National Institutes of Health, Bethesda, MD), where MNV were manually demarcated in the en-face OCTA images and isolated from the surrounding tissues using the polygon selection tool. The B scans of the respective device were used to help delineate the MNV precisely.…”

Section: Methodsmentioning

confidence: 99%

<p>Quantitative Comparison of the Vascular Structure of Macular Neovascularizations Between Swept-Source and Spectral-Domain Optical Coherence Tomography Angiography</p>

Faatz

Rothaus

Ziegler

et al. 2020

OPTH

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The aim of this study was to ascertain and quantify the differences between sweptsource (SS) and spectral-domain (SD) optical coherence tomography angiography (OCTA) imaging of macular neovascularizations (MNV) in neovascular age-related macular degeneration (nAMD). Patients and Methods: SD-OCTA (RTVue Avanti) and SS-OCTA (PLEX ® Elite 9000) were performed in 37 patients with MNV in nAMD. The MNV was delineated and the data were processed via ImageJ. The parameters MNV area, nodes per area, fractal dimension (FD), and flow density were analyzed using MatLab. Results: There was close agreement between the two devices regarding MNV area (ICCc 0.977, ICCa 0.977, R 2 0.977), but only slight agreement regarding nodes per area (ICCa 0.008, ICCc 0.548, R 2 0.51), FD (ICCa 0.425, ICCc 0.846, R 2 0.96), and flow density (ICCa 0.451, ICCc 0.656, R 2 0.65). The difference between the two devices was insignificant for MNV area (type 1: p=0.328; type 2: p=0.426; type 3: p=0.615), but significant for nodes per area (type 1: p=0.002; type 2: p=0.00001; type 3: p=0.003), FD (type 1: p<0.00001; type 2: p<0.00001; type 3: p=0.015) and flow density (type 1: p=0.0004; type 2: p=0.004; type 3: p=0.052). Conclusion: MNV area is closely comparable between devices using SS-OCTA and SD-OCTA imaging. However, the two methods differ significantly in their precise assessment of the vascular morphology (FD, flow density, nodes per area). Therefore, results obtained using different devices are not comparable and should not be amalgamated in clinical trials.

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“…In cases where segmentation artifacts made it difficult to visualize the entire CNVM complex, manual segmentation was done using tools in the software and custom slabs were created to visualize the CNVM in its entirety, as per protocols described by Siggel et al [16].…”

Section: Optical Coherence Tomography Angiographymentioning

confidence: 99%

“…We found that automated segmentation provided by the machine was reliable in less than half the cases in our series. In an excellent study published recently, Siggel et al studied 102 eyes to determine the sensitivity and specificity of automated versus manually segmented OCTA images to detect presence of CNVM [16]. They showed that automated slabs at the ORCC had the highest ability to detect CNVM compared to the gold standard FFA, while slabs at the choriocapillaris level had the lowest.…”

Section: Plos Onementioning

confidence: 99%

Need for manual segmentation in optical coherence tomography angiography of neovascular age-related macular degeneration

Dabir

Bhatt

Bhatt³

et al. 2020

PLoS ONE

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Purpose To compare the characteristics of eyes that had manual vs. automated segmentation of choroidal neovascular membrane (CNVM) using optical coherence tomography angiography (OCTA). Methods All patients with CNVM underwent OCTA using the Zeiss Angioplex Cirrus 5000. Slabs of the avascular outer retina, outer retina to choriocapillaris (ORCC) region and choriocapillaris were generated. Manual segmentation was done when there were significant segmentation artifacts. Presence of activity of CNVM was adjudged by the presence of subretinal fluid (SRF) on structural OCT and was compared to activity detected on en face OCTA slabs based on well-defined criteria. Results Eighty-one eyes of 81 patients were recruited of which manual segmentation was required in 46 (57%). Eyes with automated segmentation had significantly more CNVM in the ORCC (75%) whereas those with manual segmentation had deeper CNVM (sub-RPE = 22%, intra-PED = 22%) (p<0.001). Twenty eyes (25%) were found to have active CNVM on both the structural OCT and OCTA while an additional 19 eyes were presumed to have active CNVM on OCTA alone. There was only modest concordance between disease activity detected using structural OCT and OCTA (Kappa = 0.47, 95% CI = 0.30 to 0.64). Conclusions Manual segmentation of OCTA is required in more than 50% eyes with CNVM and this progressively increases with increasing depth of CNVM location from the ORCC to below the RPE. There is moderate concordance between OCTA and structural OCT in determining CNVM activity.

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Comparison of Automated versus Manually Modified OCT Angiography En Face Slabs for Detection of Choroidal Neovascularization

Cited by 9 publications

References 22 publications

Biomarkers in Early Response to Brolucizumab on Pigment Epithelium Detachment Associated with Exudative Age-Related Macular Degeneration

Biomarkers in Early Response to Brolucizumab on Pigment Epithelium Detachment Associated with Exudative Age-Related Macular Degeneration

<p>Quantitative Comparison of the Vascular Structure of Macular Neovascularizations Between Swept-Source and Spectral-Domain Optical Coherence Tomography Angiography</p>

Need for manual segmentation in optical coherence tomography angiography of neovascular age-related macular degeneration

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