Repeatability, interocular correlation and agreement of quantitative swept-source optical coherence tomography angiography macular metrics in healthy subjects

Fang, Danqi; Tang, Fang; Huang, Haifan; Cheung, Carol Y.; Chen, Haoyu

doi:10.1136/bjophthalmol-2018-311874

Cited by 45 publications

(45 citation statements)

References 28 publications

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“… 28 , 39 Conversely, this sensitivity itself may represent a potential liability as small errors in FAZ segmentation would have a more significant impact on the acircularity than on the area as well as cause a decrease in repeatability. 1 , 51 Similar issues relating to metric sensitivity are seen with adaptive optics retinal images of the cone mosaic, where true cone degeneration is confounded by errors in cone identification. To fully characterize cone mosaic metrics, Cooper et al 58 simulated variable loss of cones from real images of the cone mosaic to monitor how different metrics respond to that loss, enabling a head-to-head comparison of the relative sensitivity of each metric.…”

Section: Discussionmentioning

confidence: 94%

“… 1 , 21 A limitation of our study is that the majority of subjects were Caucasian (78.9%). Area is known to be larger in African, 53 Japanese, 54 and Chinese 51 , 55 , 56 subjects compared to Caucasian subjects. It seems likely that race/ethnicity-specific normative databases will be required to fully leverage area (and possibly other FAZ metrics) as biomarkers for detecting and monitoring retinal and systemic vascular diseases.…”

Section: Discussionmentioning

confidence: 95%

“…The mean (±SD) area in our study of 0.278 ± 0.101 mm 2 is very similar to that reported in other recent studies of 0.266 to 0.284 (±0.09–0.11) mm 2 . 19 , 22 – 25 , 51 However, accuracy of the reported area is dependent on multiple factors, including the method used to segment the FAZ 1 , 24 , 49 , 52 and whether or not the image scale was corrected for ocular magnification due to individual differences in axial length. 1 , 21 Not correcting for axial length can result in errors in the estimated FAZ area of up to 51%.…”

Section: Discussionmentioning

confidence: 99%

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Variability of Foveal Avascular Zone Metrics Derived From Optical Coherence Tomography Angiography Images

Linderman

Muthiah

Omoba

et al. 2018

Trans. Vis. Sci. Tech.

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PurposeTo characterize sources of inter- and intrasubject variability in quantitative foveal avascular zone (FAZ) metrics.MethodsTwo 3×3-mm optical coherence tomography angiography scans (centered on the fovea) were acquired in both eyes of 175 subjects. An image of the superficial plexus was extracted from each scan and segmented twice by a single observer. Four quantitative FAZ morphology metrics (area, axis ratio, acircularity, major horizontal axis angle) were calculated, and a variance components analysis was performed.ResultsMean (±SD) age was 27.9 ± 11.9 years, and 55% were female. Area had the largest amount of variance resulting from intersubject differences (93.1%). In contrast, there was large interocular variance for axis ratio, acircularity, and major horizontal axis angle (55.0%, 53.7%, 70.7%, respectively), though only axis ratio showed significant asymmetry between fellow eyes (P < 0.05). Neither repeated images from the same eye nor repeated segmentation on the same image were significant sources of variance.ConclusionsMetrics of FAZ morphology show excellent repeatability and reliability. Excluding FAZ area, there was a high amount of variance attributed to interocular differences for the other FAZ metrics; therefore, the fellow eye should not be considered a control for FAZ studies when using these metrics.Translational RelevanceVision scientists must be prudent when choosing FAZ metrics, as they display varying degrees of within-subject differences relative to between-subject differences. It seems likely that different metrics will be best suited for different tasks, such as monitoring small changes over time within a single subject or assessing whether a given FAZ is abnormal.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

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Variability of Foveal Avascular Zone Metrics Derived From Optical Coherence Tomography Angiography Images

Linderman

Muthiah

Omoba

et al. 2018

Trans. Vis. Sci. Tech.

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“…Despite this, OCT-A artifacts are common, particularly the projection artifacts, which are the fluctuating shadows cast by the flowing blood cells in the overlying retinal vessels projecting to the deeper layers [6,7]. However, the preexisting studies, which apply OCT-A to investigate the correlation of quantitative DCP metrics with DR and visual acuity (VA), have not effectively addressed in their findings the issue of projection artifacts [8][9][10][11]. Failure to consider this disruption in the vessel networks affects the accurate interpretation of DCP.…”

Section: Introductionmentioning

confidence: 99%

Clinically relevant factors associated with quantitative optical coherence tomography angiography metrics in deep capillary plexus in patients with diabetes

et al. 2020

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Background: To test clinically relevant factors associated with quantitative artifact-free deep capillary plexus (DCP) metrics in patients with diabetes mellitus (DM). Methods: 563 eligible eyes (221 with no diabetic retinopathy [DR], 135 with mild DR, 130 with moderate DR, and 77 with severe DR) from 334 subjects underwent optical coherence tomography-angiography (OCT-A) with a swept-source OCT (Triton DRI-OCT, Topcon, Inc., Tokyo, Japan). Strict criteria were applied to exclude from analysis those DCP images with artifacts and of poor quality, including projection artifacts, motion artifacts, blurriness, signal loss, B-scan segmentation error, or low-quality score. A customized MATLAB program was then used to quantify DCP morphology from the artifact-free DCP images by calculating three metrics: foveal avascular zone (FAZ), vessel density (VD), and fractal dimension (FD). Results: 166 (29.5%) eyes were excluded after quality control, leaving in the analysis 397 eyes (170 with no DR, 101 with mild DR, 90 with moderate DR, 36 with severe DR) from 250 subjects. In the multiple regression models, larger FAZ area was associated with more severe DR (β = 0.687; p = 0.037), shorter axial length (AL) (β = − 0.171; p = 0.003), thinner subfoveal choroid thickness (β = − 0.122; p = 0.031), and lower body mass index (BMI) (β = − 0.090; p = 0.047). Lower VD was associated with more severe DR (β = − 0.842; p = 0.001), shorter AL (β = 0.107; p = 0.039), and poorer visual acuity (VA) (β = − 0.133; p = 0.021). Lower FD was associated with more severe DR (β = − 0.891; p < 0.001) and with older age (β = − 0.142; p = 0.004). Conclusions: Quantitative artifact-free DCP metrics are associated with VA, DR severity, AL, subfoveal choroidal thickness, age, and BMI in diabetic patients. The effects of ocular and systemic factors should be considered for meaningful interpretations of DCP changes in DM patients.

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“…Due to the close similarity to humans in terms of optical structure and function, nonhuman primates such as cynomolgus macaques play a crucial role in ophthalmic disease research [10][11][12][13] . The FFA and OCT-A vascular parameters for normal humans have been previously reported 1,14,15 . Researchers have reported flow perfusion parameters for normal rhesus monkeys 16 and chorioretinal structure and stratification of cynomolgus macaques and rhesus monkeys by SD-OCT 17,18 .…”

Section: Introductionmentioning

confidence: 99%

Comparison of vascular parameters between normal cynomolgus macaques and healthy humans by optical coherence tomography angiography

Peng

Zhong

et al. 2019

Preprint

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Background: The metabolic activity of retina is higher than other human tissues and is crucial to the vision. Cynomolgus macaques is widely used in ophthalmic disease research. The evaluation and comparison of macular and optic disc vascular circulation parameters between normal adult cynomolgus macaques and healthy adult humans using OCT-A can promote better use of nonhuman primate models in studies of ophthalmic vascular disease. Methods: 12 normal adult cynomolgus macaques with a mean age of 4.91±0.43 years were studied for data collection. The macula of 28 adult healthy humans (14 males and 14 females), with a mean age of 25.11±6.21 years and the optic discs of 9 adult healthy humans (4 males and 5 females) with a mean age of 28.56±6.78 years were measured. The vessel density (VD) was measured using an RTVue XR with AngioVue. The scan sizes of the macular and optic discs were 3×3 mm and 4.5×4.5 mm, respectively. Results: OCT-A can image the superficial and deep capillary plexuses and radial peripapillary capillary network. In RPC layer of the optic disc, the VD in the nasal quadrant was lower than the VD in the inferior temporal quadrant. Similarities and significant differences in VD between healthy humans and cynomolgus macaques were obtained using OCT-A. Conclusions: This study provides normal vascular parameters for adult cynomolgus macaques using OCT-A to help establish an optical parameter database for cynomolgus macaques and compare VD between healthy humans and cynomolgus macaques to promote choroid-retinopathy research. Trial registration: Current Controlled Trials NCT03692169, retrospectively registered on 26 sept 2018 Keywords: Cynomolgus macaques, Healthy humans, Vascular, Optical coherence tomography angiography (OCT-A), Vessel density (VD)

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Repeatability, interocular correlation and agreement of quantitative swept-source optical coherence tomography angiography macular metrics in healthy subjects

Abstract: The macular metrics obtained using SS-OCTA showed excellent repeatability in healthy subjects. We showed high intereye correlation in FAZ area and perimeter, moderate correlation in fractal dimension and VDI, while vessel density had poor correlation in normal healthy subjects.

Cited by 45 publications

References 28 publications

Variability of Foveal Avascular Zone Metrics Derived From Optical Coherence Tomography Angiography Images

Variability of Foveal Avascular Zone Metrics Derived From Optical Coherence Tomography Angiography Images

Clinically relevant factors associated with quantitative optical coherence tomography angiography metrics in deep capillary plexus in patients with diabetes

Comparison of vascular parameters between normal cynomolgus macaques and healthy humans by optical coherence tomography angiography

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