Pearls and Pitfalls of Optical Coherence Tomography Angiography Imaging: A Review

Borrelli, Enrico; Sadda, Srinivas R; Uji, Akihito; Querques, Giuseppe

doi:10.1007/s40123-019-0178-6

Cited by 60 publications

(77 citation statements)

References 45 publications

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“…Furthermore, since 9×9 mm 2 was the largest frame available, the areas of rarefied flow and atrophy in ORCC and CC may have been underestimated in some patients and therefore potential differences in eyes affected by large areas of rarefied flow and atrophy went undetected. Despite the existing body of evidence suggesting that the retinal plexuses merge at the edge of the FAZ, which may be thus considered a singular structure throughout the entire foveal thickness20 21 and increased variability of measurements when assessing the FAZ size at different segments,22 we chose to investigate the FAZ area separately in different retinal capillary plexuses (SCP and DCP) so as to compare our findings to the latest literature. As a result of choriocapillary atrophy, the large choroidal vessels are detected in the corresponding areas.…”

Section: Discussionmentioning

confidence: 99%

Characterisation of vascular changes in different stages of Stargardt disease using double swept-source optical coherence tomography angiography

et al. 2019

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ObjectiveTo describe vascular changes in different stages of Stargardt disease (STGD) via double swept-source optical coherence tomography angiography.Methods and analysisProspective, cross-sectional case–control study. Twenty-three patients (45 eyes) with ABCA4 mutations graded according to the Fishman STGD classification and 23 controls (23 eyes) were included. Two independent investigators quantified the foveal avascular zone (FAZ) in the superficial and deep capillary plexus (SCP/DCP) and the areas presenting rarefied flow and complete vascular atrophy in the outer retina to choriocapillaris (ORCC) and choriocapillaris (CC) slab.ResultsThe mean age at first diagnosis of STGD was 24.0 years (range 9–50) and 37.9 years (range 18–74) at the time of examination. Eleven patients were assigned to the Fishman STGD classification stage (S) 1, three to S2, eight to S3 and one to S4. The FAZ in SCP and DCP was increased in all stages compared with controls (p<0.01). Areas with rarefied flow signal and vascular atrophy were detected in the ORCC and the CC layer and grew with increasing stage of disease (p<0.01). The duration of disease correlated with the extent of the enlarged FAZ in the SCP/DCP and with the area of reduced flow in the ORCC and CC layer (p<0.01). Best corrected visual acuity correlated negatively with the extent of the enlarged FAZ in the SCP/DCP (p<0.0001), as well as with enlarged atrophic area in the ORCC and CC layer (p=0.026 and p=0.074).ConclusionsPatients with STGD reveal vascular changes in the retina and CC in all disease stages. The avascular zone in the SCP/DCP and areas with rarefied flow signal in the ORCC/CC increase with the duration and stage of disease, indicating progressive vascular decay most likely secondary to retinal pigment epithelium and neuronal loss. Furthermore, increased vascular damage is associated with decreased vision.

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Section: Discussionmentioning

confidence: 99%

Characterisation of vascular changes in different stages of Stargardt disease using double swept-source optical coherence tomography angiography

et al. 2019

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“…OCTA has been widely used to analyze the detailed characterization of the retinal and choroidal vasculature in the macular and peripapillary regions [25][26][27]. Due to the limitations of the analysis software, only superficial vascular plexus in the macular region could be quantitatively analyzed in our study.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of retinal and choroidal variations in thyroid-associated ophthalmopathy using optical coherence tomography angiography

Qin

Cheng

et al. 2020

BMC Ophthalmol

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Background To investigate the difference in retinal nerve fiber layer (RNFL) thickness, choroidal thickness (CT) and superficial retinal vessels between thyroid-associated ophthalmopathy (TAO) patients and healthy controls. To identify the potential influencing factors for these parameters and evaluate their diagnostic abilities in TAO. Methods Twenty active TAO patients, 33 inactive TAO patients and 29 healthy participants were enrolled. TAO patients were divided according to the clinical activity score (CAS). RNFL thickness and CT were measured by HD-OCT, while foveal avascular zone (FAZ), vascular density and perfusion density were measured by optical coherence tomography angiography (OCTA). SPSS software was used for statistical analysis. Results Active TAO patients had thinner RNFL thickness than the other two groups (P < 0.001, P < 0.001). Both active and inactive TAO patients had significantly higher CT in the macular region (all P < 0.05). The FAZ area in the active TAO group was significantly larger than the other two groups (P = 0.045, P = 0.001). The inactive TAO group had significantly higher vascular density than the other two groups (all P < 0.05). With regard to the perfusion density, significant differences were observed in the temporal and inferior areas (P = 0.045, P = 0.001), as well as the average values (P = 0.032). The FAZ area was positively correlated with intraocular pressure (r = 0.274, P = 0.013), while it was negatively correlated with axial length (r = − 0.344, P = 0.002). The vascular density and perfusion density were not significantly correlated with different clinical variables (all P > 0.05). The AUC analysis indicated these parameters also exhibited a significant discriminatory power in TAO diagnosis. Conclusions TAO patients had significant variations in RNFL thickness, choroidal thickness, FAZ area and superficial retinal vessels. These parameters appeared to be potential adjuncts in the evaluation of TAO patients.

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“…OCTA has been widely used to analyze the detailed characterization of the retinal and choroidal vasculature in the macular and peripapillary regions [25][26][27]. Due to the limitations of the analysis software, only super cial vascular plexus in the macular region could be quantitatively analyzed in our study.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of retinal and choroidal variations in thyroid-associated ophthalmopathy using optical coherence tomography angiography

Qin

Cheng

et al. 2020

Preprint

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Background: To investigate the difference in retinal nerve fiber layer (RNFL) thickness, choroidal thickness (CT) and superficial retinal vessels between thyroid-associated ophthalmopathy (TAO) patients and healthy controls. To identify the potential influencing factors for these parameters and evaluate their diagnostic abilities in TAO.Methods: 20 active TAO patients, 33 inactive TAO patients and 29 healthy participants were enrolled. TAO patients were divided according to the clinical activity score (CAS). RNFL thickness and CT were measured by HD-OCT, while foveal avascular zone (FAZ), vascular density and perfusion density were measured by optical coherence tomography angiography (OCTA). SPSS software was used for statistical analysis.Results: Active TAO patients had thinner RNFL thickness than the other two groups (P<0.001, P<0.001). Both active and inactive TAO patients had significantly higher CT in the macular region (all P<0.05). The FAZ area in the active TAO group was significantly larger than the other two groups (P=0.045, P=0.001). The inactive TAO group had significantly higher vascular density than the other two groups (all P<0.05). With regard to the perfusion density, significant differences were observed in the temporal and inferior areas (P=0.045, P=0.001), as well as the average values (P=0.032). The FAZ area was positively correlated with intraocular pressure (r=0.274, P=0.013), while it was negatively correlated with axial length (r=-0.344, P=0.002). The vascular density and perfusion density were not significantly correlated with different clinical variables (all P>0.05). The AUC analysis indicated these parameters also exhibited a significant discriminatory power in TAO diagnosis.Conclusions: TAO patients had significant variations in RNFL thickness, choroidal thickness, FAZ area and superficial retinal vessels. These parameters appeared to be potential adjuncts in the evaluation of TAO patients.

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Pearls and Pitfalls of Optical Coherence Tomography Angiography Imaging: A Review

Cited by 60 publications

References 45 publications

Characterisation of vascular changes in different stages of Stargardt disease using double swept-source optical coherence tomography angiography

Characterisation of vascular changes in different stages of Stargardt disease using double swept-source optical coherence tomography angiography

Evaluation of retinal and choroidal variations in thyroid-associated ophthalmopathy using optical coherence tomography angiography

Evaluation of retinal and choroidal variations in thyroid-associated ophthalmopathy using optical coherence tomography angiography

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