Precision (repeatability and reproducibility) of papillary and peripapillary vascular density measurements using optical coherence tomography angiography in children

Abstract

ImportanceOptical coherence tomography angiography (OCTA) has been widely applied into children, however, few studies have assessed the repeatability and reproducibility of papillary and peripapillary VD in healthy children.ObjectiveTo assess the precision of papillary and peripapillary vascular density (VD) measurements using optical coherence tomography angiography (OCTA) and analyze the effects of the signal strength index (SSI) and axial length (AL) on precision estimates.Design, setting, and participantsThis was a prospective observational study. Seventy-eight children aged 6–16 years underwent 4.5 × 4.5 mm OCTA (RTVue XR Avanti) disc scans: two scans by one examiner (repeatability) and two additional scans by another examiner (reproducibility). Within-subject standard deviation (Sw), test-retest reproducibility (TRT), within-subject coefficient of variation (CoV), intraclass correlation coefficient (ICC), and Bland–Altman analysis were performed.Main outcomes and measuresIn repeatability measurement, the fluctuation ranges (minimum to maximum) of VD between intraexaminer A/B in Sw, TRT, CoV, and ICC were (1.05–2.17)% / (1.16–2.32)%, (2.9–6)% / (3.21–6.44)%, (1.9–4.47)% / (2.08–5)%, and (0.588–0.783)% / (0.633–0.803)%, respectively. In reproducibility measurement, the fluctuation ranges of VD in Sw, TRT, CoV, and ICC were 1.11–2.13%, 3.07–5.91%, 1.99–4.41%, and 0.644–0.777%, respectively. VD was negatively correlated with SSI in most sectors of the peripapillary (e.g., inferior nasal, temporal inferior, temporal superior, superior temporal, and superior nasal). AL was positively correlated with inferior temporal VD and negatively correlated with superior nasal VD.Conclusion and relevanceOptical coherence tomography angiography showed moderate-to-good repeatability and reproducibility for papillary and peripapillary perfusion measurements in healthy children. The SSI value affects most of the peripapillary VD, while AL affects only the temporal inferior and nasal superior peripapillary VD.

Papillary and peripapillary vascular densities and corresponding correlation with peripapillary retinal thicknesses using optical coherence tomography angiography in healthy children and adolescents

“…The study of optic nerve head (ONH) perfusion has been recently popularized after progression in understanding glaucoma and ONH disease pathogeneses. It has been revealed that optic nerve circulation and anatomy may be altered by ocular diseases like high myopia 2 , infantile nystagmus 3 , optic disc drusen 4 , uveitis 5 , optic neuritis 6 , optic neuropathies 7 , glaucoma 8 , 9 , central nervus system (CNS) related disorders such as migraine 10 , epilepsy 11 , CNS tumors 12 , 13 , and systemic conditions like diabetes 14 and thalassemia 15 or drug induced changes 11 , 16 in both children and adults 12 , 17 , 18 . Prompt diagnosis and management are crucial to prevent further visual impairment and promote optimal visual development.…”