Reproducibility of Vessel Density, Fractal Dimension, and Foveal Avascular Zone Using 7 Different Optical Coherence Tomography Angiography Devices

Corvi, Federico; Pellegrini, Marco; Erba, Stefano; Cozzi, Mariano; Staurenghi, Giovanni; Giani, Andrea

doi:10.1016/j.ajo.2017.11.011

Cited by 189 publications

(163 citation statements)

References 20 publications

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“…Various studies have reported the repeatability of OCTA measurements in the normal eye, but studies seem insufficient regarding the repeatability in patients with retinal diseases. [6][7][8][9][10][11] Therefore, in the present study, we determined the repeatability of VD measurements using OCTA in patients with diabetic macular oedema (DME), retinal vein occlusion (RVO) with macular oedema, epiretinal membrane (ERM) and wet age-related macular degeneration (AMD), which are relatively common in clinical field, and identified factors affecting the repeatability of these measurement.…”

Section: Introductionmentioning

confidence: 99%

Repeatability of vessel density measurements using optical coherence tomography angiography in retinal diseases

et al. 2018

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AimTo analyse the repeatability of vessel density (VD) measurements using optical coherence tomography angiography (OCTA) in patients with retinal diseases.MethodsTwo consecutive VD measurements using OCTA were analysed prospectively in patients with retinal diseases (diabetic macular oedema (DME), retinal vein occlusion (RVO) with macular oedema, epiretinal membrane (ERM), wet age-related macular degeneration (AMD)). The intraclass correlation coefficient (ICC), coefficient of variation (CV) and test-retest SD of VD measurements were assessed, and linear regression analyses were conducted to identify factors related to repeatability.ResultsA total of 134 eyes were analysed involving 20 eyes with DME, 44 eyes with RVO with macular oedema, 50 eyes with ERM and 20 eyes with wet AMD. The mean age was 64.9 years, and the mean best-corrected visual acuity (BCVA) was 0.24. The mean central macular thickness (CMT) was 391.6 µm, and the mean ganglion cell-inner plexiform layer (GC-IPL) thickness was 61.4 µm. In all four diseases, the ICC and CV of the full VD were 0.812 and 6.72%, respectively. Univariate analyses showed that the BCVA (B, 8.553; p=0.031), signal strength (B, −1.688; p=0.050), CMT (B, 0.019; p=0.015) and mean GC-IPL thickness (B, −0.103; p=0.001) were significant factors that affected the repeatability. Multivariate analyses of these factors showed a significant result for the GC-IPL thickness.ConclusionsMeasurements of the VD using OCTA showed relatively good repeatability for various retinal diseases. The BCVA, signal strength, CMT and GC-IPL thickness affected the repeatability, so these factors should be considered when analysing the VD.

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Section: Introductionmentioning

confidence: 99%

Repeatability of vessel density measurements using optical coherence tomography angiography in retinal diseases

et al. 2018

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“…Although it has been proven that the analysis provided by different OCTA devices are not interchangeable [4], the involvement of DCP in RVO eyes compared with FE at baseline was found with both OCTA devices in our series. After IVR-LP, no significant changes have been found in DCP VD with both devices.…”

Section: Discussionmentioning

confidence: 51%

“…Furthermore, Hasegawa et al [3] demonstrated that the reduction in macular VD in SCP was associated with a decrease in the number of recurrences of macular edema in BRVO patients [4]. Although it has been proven that the analysis provided by different OCTA devices are not interchangeable [4], the involvement of DCP in RVO eyes compared with FE at baseline was found with both OCTA devices in our series.…”

Section: Discussionmentioning

confidence: 51%

“…The first device is a spectral-domain OCTA that provides 4 automated segmented scans at the level of SCP, DCP, outer retina, and CC, using an algorithm called split-spectrum amplitude-decorrelation algorithm [4]. …”

Section: Methodsmentioning

confidence: 99%

“…Several OCTA devices that use a different algorithm to detect the blood flow from the retina to the Ch are available. Unfortunately, the analysis provided by these instruments are not always interchangeable [4]. …”

Section: Introductionmentioning

confidence: 99%

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Microvascular Retinal and Choroidal Changes in Retinal Vein Occlusion Analyzed by Two Different Optical Coherence Tomography Angiography Devices

et al. 2019

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Purpose: To investigate retinal and choroidal microvascular changes and structural choroidal involvement in retinal vein occlusion (RVO). Methods: Retrospective analysis of treatment-naïve macular edema secondary to RVO, studied by optical coherence tomography (OCT) and OCT angiography (OCTA), before and after the loading phase of intravitreal injections of ranibizumab (IVR-LP). OCTA was performed using two different devices: AngioVue RTVue XR Avanti (spectral-domain OCTA) and Zeiss PLEX® Elite 9000 (swept-source OCTA). Results: 30 eyes of 30 consecutive patients (17 branch and 13 central RVO) were included. Central macular thickness and subfoveal choroidal thickness (SCT) were significantly reduced after IVR-LP (p < 0.001 and p = 0.046, respectively). 23 eyes were eligible for OCTA analysis. Baseline vessel density (VD) in deep capillary plexus (DCP) was significantly reduced in RVO eyes compared with fellow eyes (p = 0.03 and p = 0.002 for PLEX® Elite and AngioVue, respectively). After IVR-LP, no significant VD changes in any vascular layer was found. PLEX® Elite VD analysis showed significant differences in DCP between ischemic versus non-ischemic eyes (p = 0.011). Conclusion: OCTA suggests a retinal vascular impairment of DCP but no involvement of choroid in RVO eyes. A greater baseline SCT could be due to a choroidal exudation. OCTA imaged with PLEX® Elite allowed to differentiate ischemic and non-ischemic patients at baseline.

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Quantitative Microvascular Analysis With Wide-Field Optical Coherence Tomography Angiography in Eyes With Diabetic Retinopathy

et al. 2020

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IMPORTANCE Wide-field optical coherence tomographic angiography (OCTA) may provide insights to peripheral capillary dropout in eyes with diabetic retinopathy (DR).OBJECTIVE To describe the diagnostic performance of wide-field OCTA with and without large vessel removal for assessment of DR in persons with diabetes. DESIGN, SETTING, AND PARTICIPANTSThis case-control study was performed from April 26, 2018, to April 8, 2019, at a single tertiary eye center in Singapore. Case patients were those with type 2 diabetes for more than 5 years and bilateral DR diagnosed by fundus imaging; control participants included those with no self-reported history of diabetes, a fasting glucose level within the normal range in the past year, and no ocular pathologic findings. A wide-field (12 × 12-mm 2 ) fovea-centered scan was performed using a prototype swept source OCTA system. Retinal microvasculature was examined by separating the angiograms into large vessels, capillaries, and capillary dropout regions. MAIN OUTCOMES AND MEASURES Area under the receiver operating characteristic curve (AUC)for DR severity discrimination using wide-field vascular metrics. Retinal perfusion density (RPD), capillary perfusion density (CPD), large vessel density (LVD), and capillary dropout density (CDD) were calculated. Low-contrast regions were excluded from the calculation. RESULTSA total of 49 eyes in 27 control participants (17 male [63.0%]; mean [SD] age, 59.96 [7.63] years; age range, 44-79 years) and 76 eyes in 47 patients with diabetes (29 male [61.7%]; mean [SD] age, 64.36 [8.08] years; range, 41-79 years) were included. Among eyes in patients with diabetes, 23 were in those with diabetes but no DR, 25 in those with mild nonproliferative DR, and 28 in those with moderate to severe nonproliferative DR. There was no difference in RPD, CPD, LVD, and CDD between the control group and the group with diabetes and no DR. There was a stepwise decrease in RPD, CPD, and CDD in the diabetes with no DR, mild nonproliferative DR, and moderate to severe nonproliferative DR groups, whereas LVD was not associated with DR staging. The nonproliferative DR group had decreased RPD, CPD, and CDD compared with the control group. The CPD had higher AUCs than RPD for discriminating diabetes with nonproliferative DR (combined mild and moderate to severe nonproliferative DR) vs no DM (AUC, 0.92 [95% CI, 0.87-0.98] vs 0.89 [95% CI, 0.83-0.95], P = .01), diabetes with no DR vs mild nonproliferative DR (AUC, 0.81 [95% CI, 0.68-0.94] vs 0.77 [95% CI, 0.64-0.91], P = .18), and mild nonproliferative DR vs moderate to severe nonproliferative DR (AUC, 0.82 [95% CI, 0.71-0.94] vs 0.78 [95% CI, 0.65-0.91], P = .01) but similar AUCs for no DM vs diabetes with no DR. The total perfusion density and CPD in wide-field OCTA had better discriminative power than the central 6 × 6-mm 2 field (CPD, 0.89 [95% CI, 0.83-0.95] vs 0.84 [95% CI, 0.77-0.92], P = .06; total perfusion density, 0.93 [95% CI, 0.87-0.98] vs 0.90 [95% CI, 0.83-0.96], P = .06).(continued) Key Points Question Wha...

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Reproducibility of Vessel Density, Fractal Dimension, and Foveal Avascular Zone Using 7 Different Optical Coherence Tomography Angiography Devices

Cited by 189 publications

References 20 publications

Repeatability of vessel density measurements using optical coherence tomography angiography in retinal diseases

Repeatability of vessel density measurements using optical coherence tomography angiography in retinal diseases

Microvascular Retinal and Choroidal Changes in Retinal Vein Occlusion Analyzed by Two Different Optical Coherence Tomography Angiography Devices

Quantitative Microvascular Analysis With Wide-Field Optical Coherence Tomography Angiography in Eyes With Diabetic Retinopathy

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