Repeatability and Reproducibility of 4.5 by 4.5 mm Peripapillary Optical Coherence Tomography Angiography Scans in Glaucoma and Non-Glaucoma Eyes

Abstract

Précis: Peripapillary vessel parameters from optical coherence tomography angiography (OCTA) 4.5×4.5 mm scans in nonglaucomatous and glaucomatous eyes showed high repeatability and reproducibility, with higher reliability for commercially developed OCTA parameters compared with custom OCTA parameters. Purpose:The purpose of this study was to assess intrasession repeatability versus intersession reproducibility of peripapillary vessel parameters from 4.5×4.5 mm OCTA scans in nonglaucomatous eyes and glaucomatous eyes. Materials and Methods:In a longitudinal study, peripapillary OCTA scans were quantified using research-oriented custom quantification software that calculated vessel area density (VAD) and flux and clinic-oriented commercially developed software (Cirrus 11.0) that calculated perfusion density (PD) and flux index (FI). Intrasession repeatability and intersession reproducibility were evaluated using within-eye coefficient of variation (CV W ) and intraclass correlation coefficient (ICC).Results: With 127 nonglaucomatous eyes, intrasession CV W for VAD, PD, flux, and FI were 1.900%, 1.174%, 2.787%, and 1.425%, respectively. The intersession CV W were 2.039%, 1.606%, 4.053%, and 2.798%, respectively. Intrasession ICC ranged from 0.903 to 0.956, and intersession ICC ranged from 0.850 to 0.896. Among 144 glaucomatous eyes, intrasession CV W for VAD, PD, flux, and FI were: 3.841%, 1.493%, 5.009%, and 2.432%, respectively. The intersession CV W were 4.991%, 2.155%, 6.360%, and 3.458%, respectively. Intrasession ICC ranged from 0.956 to 0.969, and intersession ICC ranged from 0.918 to 0.964.Conclusions: Among nonglaucomatous and glaucomatous eyes, the majority of peripapillary OCTA vessel parameters from 4.5×4.5 mm scans had greater intrasession repeatability than intersession reproducibility. There was a greater agreement for the commercially developed quantification parameters than for their custom quantification counterparts.

Peripapillary Perfusion Analysis Using Optical Coherence Tomography Angiography in Patients with Normal Tension Glaucoma

“…The imaging modality used in our study, Zeiss Angio-Plex based on the OMAG system, is a spectral-domain OCTA with complex signal-based OMAG and is one of the most widely used commercially available OCT systems in actual clinical settings. Past studies have shown better repeatability and reproducibility in 4.5 × 4.5-mm sized scans of the radial peripapillary capillary plexus and macula compared to the 6 × 6-mm sized images of the previous version [4,36]. The results of the study using peripapillary images were similar even when the scans were taken from the same clinical setting using the same technology [36].…”

“…Past studies have shown better repeatability and reproducibility in 4.5 × 4.5-mm sized scans of the radial peripapillary capillary plexus and macula compared to the 6 × 6-mm sized images of the previous version [4,36]. The results of the study using peripapillary images were similar even when the scans were taken from the same clinical setting using the same technology [36]. The significance of the current study lies in the examination of the values of vascular parameters derived from the most commercially available OCTA in glaucoma clinics and the investigation of the correlation of vascular parameters with representative structural and functional parameters.…”

“…To overcome the limitations of this study's cross-sectional design, unreliable OCTA images with significant motion artifacts or structural defects were excluded. Previous studies have also shown that OCTA measurements have reasonable intra-visit repeatability and inter-visit reproducibility [4,[36][37][38]. Due to the limitations of its cross-sectional study design, the current study did not include patients with preperimetric glaucoma or glaucoma suspects which could have potentially altered the diagnostic ability of OCTA.…”

Retinal Ganglion Cell Function and Perfusion following Intraocular Pressure Reduction with Preservative-Free Latanoprost in Patients with Glaucoma and Ocular Hypertension

“…It would be useful to investigate the repeatability and reproducibility of our device and software in control subjects to determine whether a difference in OCTA parameter measurements in a given patient is clinically significant or within the accepted “noise” of the technology and the patient’s daily physiological variation. Studies have shown good intra-session repeatability and good inter-session reproducibility of OCTA vessel parameter measurements in healthy and glaucomatous eyes using commercial software for OCTA devices [ 43 , 44 , 45 , 46 ]. The inter-session coefficient of repeatability is the best measure for this assessment as it represents the estimated range in which the difference between two repeated measurements for a given eye falls 95% of the time [ 43 ].…”