Reproducibility of macular and optic nerve head vessel density measurements by swept-source optical coherence tomography angiography

Abstract

<jats:sec><jats:title>Purpose:</jats:title><jats:p> To assess the reproducibility of swept-source optical coherence tomography angiography (SS-OCTA) for macular and optic nerve head (ONH) vessel density (VD). </jats:p></jats:sec><jats:sec><jats:title>Methods:</jats:title><jats:p> Cross-sectional study using the Triton OCTA (Topcon, Tokyo, Japan), for VD (%) measurements in 40 eyes of 40 healthy subjects on two 6 × 6 mm scans of the macula and ONH across five subfields (central, superior, inferior, temporal, and nasal) at different segmentation levels: superficial capillary plexus (SCP), deep capillary plexus (DCP), outer retina, and choriocapillaris. Reproducibility values were summarized as intraclass correlation coefficients (ICCs) and coefficients of variations (CV). </jats:p></jats:sec><jats:sec><jats:title>Results:</jats:title><jats:p> ICCs for the macular VD measurements in the central zone were 0.874, 0.770, 0.575, 0.718 at the levels SCP, DCP, outer retina, and choriocapillaris, respectively, while worse ICCs were obtained for the parafoveal subfields (ICC ⩽ 0.589); CVs were 2.8%–6.7%. The reproducibility of the ONH superficial VD was ICC = 0.941 for the papillary region and was ICC = 0.499–0.853 for the peripapillary zone; CVs ranged from 4.8% to 17%. Peripapillary VD showed an ICC = 0.533–0.770 in the DCP layer, and 0.572–0.828 in the choriocapillaris. Lowest VD were obtained for the macular SCP and DCP (23% and 22%, respectively), in the foveal zone, while greatest VD were recorded in the nasal and temporal peripapillary subfields at the level of the choriocapillaris (both 68%). </jats:p></jats:sec><jats:sec><jats:title>Conclusions:</jats:title><jats:p> The new SS-OCTA software served to quantify macular and ONH VD with a reproducibility that was good in the central zones (foveal and papillary, respectively) and moderate in the peripheral zones (parafoveal and peripapillary). </jats:p></jats:sec>

Papillary Vessel Density Changes after Intravitreal Anti-VEGF Injections in Hypertensive Patients with Central Retinal Vein Occlusion: An Angio-OCT Study

“…A recent study showed that VD measurement by OCTA presents a good to moderate reproducibility in peripapillary region and a good reproducibility in papillary region, validating this area as a well-founded field of interest [40]. Manalastas et al [41] described a similar good reproducibility of OCTA optic nerve head measurements using Optovue software.…”

Normative database and determinants of macular vessel density measured by optical coherence tomography angiography

“…Using the Triton device, we previously reported the good reproducibility of VD measurements for the fovea (intraclass correlation coefficient, ICC ≥.718 for SCP, DCP and CC) and moderate reproducibility for the parafoveal sectors (ICC .320-.589). 27 Other authors have also reported good reproducibility for the use of different OCTA devices (RTVue Avanti, Fremont, California; ICC ≥ .873) 6 or the Plex Elite (Carl Zeiss Meditec, Jena, Germany; ICC ≥ .70). 28 Our data reveal mean VDs in the foveal subfield of 22.1% ± 5.0% and 19.9% ± 6.3% in the SCP and DCP, respectively, the difference being significant (P < .001).…”

“…5 Conversely, Shahlaee et al described similar VD measurements in fellow eyes as well as no sex differences (P > .05). 27 Interestingly, some authors have described that some degree of asymmetry in blood flow between both eyes could be due to a lack of anatomic symmetry at the aortic arch (the origin of the right common carotid artery lays in the brachiocephalic trunk instead of emerging directly from the aorta, as the left common carotid artery). Magrath et al also compared both eyes of the same subjects, observing no significant differences independently of the machine or measurement technique employed.…”

“…We think this is likely due to the better reproducibility of VDs observed previously by us in the foveal region than in the remaining subfields. 27 Interestingly, some authors have described that some degree of asymmetry in blood flow between both eyes could be due to a lack of anatomic symmetry at the aortic arch (the origin of the right common carotid artery lays in the brachiocephalic trunk instead of emerging directly from the aorta, as the left common carotid artery). 30,31 Negative correlation between VD and age persisting after adjusting for signal strength has been described by Coscas et al and Shahlaee et al 5,6 Iafe et al also observed a VD decline with age accompanied by an expanded FAZ.…”

Evaluation of Foveal and Parafoveal Microvascular Changes Using Optical Coherence Tomography Angiography in Type 2 Diabetes Patients without Clinical Diabetic Retinopathy in South Korea

“…OCTA can selectively visualize specific retinal layers, which can be used to compare microvascular changes in patients without detectable clinical retinopathy [ 12 , 13 ]. There is evidence that OCTA can identify subclinical microvascular alteration in various diseases.…”