Repeatability of Peripapillary Optical Coherence Tomography Angiography Parameters in Older Adults

2020 ◽  
pp. 247412642095396
Author(s):  
Cason B. Robbins ◽  
Dilraj S. Grewal ◽  
Atalie C. Thompson ◽  
Stephen P. Yoon ◽  
Brenda L. Plassman ◽  
...  

Purpose: This work assesses the intrasession repeatability of capillary perfusion density (CPD) and capillary flux index (CFI) measurements on peripapillary optical coherence tomography angiography (OCTA) in healthy eyes of older adults. Methods: In this cross-sectional study, healthy volunteers aged 50 years or older underwent 4.5 × 4.5 mm OCTA imaging centered on the optic nerve head using Zeiss Cirrus HD-5000 AngioPlex (Carl Zeiss Meditec). Two consecutive images were acquired in the same eye during a single study session. CPD and CFI were assessed using AngioPlex Software (version 11.0.0.29946) for the radial peripapillary capillary plexus (average over whole scan area) and 4 quadrants (superior, inferior, temporal, and nasal). CPD and CFI repeatability was assessed by intraclass correlation (ICC), mean interocular differences using 2-tailed t test, and association with age using generalized estimating equations. Results: A total of 150 images were acquired from 75 eyes of 47 patients. For CPD, ICC results ranged from 0.7160 (nasal CPD) to 0.9218 (average CPD). For CFI, ICC results ranged from 0.6167 (temporal CFI) to 0.8976 (inferior CFI). Temporal CFI was significantly different between right and left eyes of the same patient ( P = .03). CPD and CFI decreased with age in all analyses (average CPD β coefficient –0.00172, P < .001; average CFI β coefficient −0.00278, P < .001). Conclusions: Moderate to good repeatability was observed for most peripapillary OCTA metrics; temporal measurements were least repeatable for CPD and CFI. Peripapillary CPD and CFI decrease with age even beyond the fifth decade in healthy older adults.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jing Zhai ◽  
Wei Fang ◽  
Xueting Yu ◽  
Xinjie Ye ◽  
Lijie Hou

Abstract Background To quantify and compare retinal microvascular features using optical coherence tomography angiography (OCTA) in constant (XT) and intermittent exotropia (IXT). Methods An observational cross-sectional study was conducted from September 2020 to November 2020 at the Affiliated Eye Hospital of Wenzhou Medical University. OCTA examination was performed to evaluate the macular perfusion density of the deep capillary plexus (DCP), superficial capillary plexus (SCP), and foveal avascular zone (FAZ) parameters in XT and IXT patients, and in age-matched controls. The study parameters were analyzed. Results A total of 76 participants, including 16 (21%) XT patients, 24 (32%) IXT patients, and 36 (47%) controls, were recruited. The exodeviation angle was 39.06 ± 10.38 prism degrees (PD) at near and 43.00 ± 9.74 PD at distance in the XT group, and 27.13 ± 18.28 PD at near and 31.04 ± 18.82 PD at distance in the IXT group. The macular perfusion density of the DCP in 6 × 6-mm scans and the SCP in 3 × 3-mm scans were lower in the deviating eyes than in the fixating eyes of XT patients (p < 0.001, p = 0.032, respectively). The macular perfusion density of the DCP in the deviating eyes of XT and IXT patients was significantly lower than that of the controls. There was no significant difference in the FAZ parameters among the groups. Conclusions In XT patients, OCTA revealed lower macular perfusion density in deviating eyes than in fixating eyes and control eyes. IXT patients showed no difference between the two eyes, but the macular perfusion density of the DCP was lower than that of the controls.


2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Jingyuan Yang ◽  
Mingzhen Yuan ◽  
Erqian Wang ◽  
Youxin Chen

The aim of this study was to compare the repeatability of optical coherence tomography angiography (OCT-A) measurements of macular vessel density using four OCT-A systems, including Heidelberg Spectralis HRA, Optovue RTVue XR, Zeiss Cirrus HD-OCT 5000, and Topcon DRI OCT Triton. A cross-sectional design was used for this study. The vascular density and vascular length density of the superficial and deep retinal capillary plexuses were imaged with OCT-A using 3 mm and 6 mm scan patterns and were calculated using ImageJ. Comparisons of intraclass correlation coefficients (ICC) were conducted. We found that the OCT-A systems had various levels of repeatability. Zeiss had better repeatability for vessel density than the other systems (overall ICC = 0.936). Optovue had better repeatability for vessel length density when the 6 mm scan pattern was used (ICC = 0.680 and 0.700 for retinal superficial and deep capillary plexus, respectively). We concluded that repeatability varied when different scan patterns of various OCT-A systems were used for imaging the superficial retinal and deep capillary plexuses. Results should be seen as valid only for a given method. The repeatability of various OCT-A systems should be considered in clinical practice and in clinical trials that use OCT-A metrics as outcome measures.


Author(s):  
Fariba Ghassemi ◽  
Vahid Hatami ◽  
Farhad Salari ◽  
Fatemeh Bazvand ◽  
Hadi Shamouli ◽  
...  

Abstract Background This study aimed at defining the variance of vessel density (VD) characteristics in the macula of children with normal eyes. Methods This was a cross-sectional study in which subjects with normal eyes aged 3–18 years were enrolled. The macula was scanned by optical coherence tomography angiography (OCTA). Four age groups as under 7 years, 7–10 years, 11–14 years and more than 14 years of age were defined. The influences of age, gender, and body mass index on VD were analyzed. Results A total of 108 normal eyes from 54 participants with a mean age of 10.9 years were enrolled in the study. At the superficial and deep retina capillary plexus (SCP and DCP) and choriocapillaris (CC), respectively, the mean VD of the fovea was 20.10%, 36.99%, and 75.67%; at parafovea, these measurements were 53.12%, 55.81%, and 69.76%; and at perifovea, these measures were 51.38%, 52.46%, and 73.47%. The median foveal avascular zone (FAZ) was 0.30 mm2. No significant differences between superior-hemi VD and inferior-hemi VD were found in the studied plexuses. The VD at parafovea and perifovea CC differed significantly between groups. There was no variation in VD of macular retina and CC between eyes or sex. FAZ areas were different between genders. Conclusions No difference between eyes and genders in the retina and CC VD of macular area was noted. FAZ area was larger in male. Even though this is not a longitudinal study, it may provide us with hints about macular vascular development during puberty and clinical implications of OCTA in children.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Dunja Bajtl ◽  
Mirjana Bjeloš ◽  
Mladen Bušić ◽  
Ana Križanović ◽  
Leon Marković ◽  
...  

Abstract Background The purpose of this cross-sectional study involving healthy emmetropic four-year-old Caucasian children was to provide a macular perfusion normative database acquired with optical coherence tomography angiography (OCTA). One eye of each examinee underwent OCTA imaging. The following parameters were analyzed using AngioTool Image J software: vessels area (VA), vessels density (VD), total number of junctions (TNJ), junctions density (JD), total vessel length (TVL), average vessel length (AVL), total number of endpoints (TNEP), lacunarity (L), vessel diameter index (VDI), tortuosity (T) and foveal avascular zone (FAZ). Average central macular thickness (CMT) and average central macular volume (CMV) were measured. Result Sixty-two eyes of 62 children of average age 50.4 ± 3.8 months were examined. VA, VD, and T increased from the inner towards the outer layers of the retina. The intermediate capillary plexus had the highest JD and TNEP and narrowest FAZ. Retinal sexual differentiation was supported with higher values of the retinal VA, VDI and TNEP, and chorioretinal VA, VDI and L in males. The choriocapillaris presented with the highest VD, AVL, and T and the lowest L and TNEP. Conclusion The study provides the first detailed normative database of the macular vascular network in the youngest uniform cohort of emmetropic four-year-old children.


2020 ◽  
Author(s):  
Laura Gutierrez-Benitez ◽  
Yolanda Palomino ◽  
Noe Casas

PURPOSE: To develop and evaluate an automated method to measure the foveal avascular zone (FAZ) area in healthy eyes on Heidelberg Spectralis Optical Coherence Tomography Angiography (HS-OCTA). This method is referred to as the modified Kanno-Saitama macro (mKSM). METHODS: This cross-sectional study included 29 eyes of 25 healthy volunteers who underwent HS-OCTA at the macular area twice at the same time. Regardless of the quality of the images, all of them were included. Macular data on the superficial vascular plexus, intermediate capillary plexus and deep capillary plexus were processed by mKSM. The FAZ area was measured twice automatically using the mKSM and twice manually by two independent examiners. RESULTS: Intrascan intraclass coefficient ranged from 0,948 to 0,993 for manual measurements and was 1 for mKSM method. Interscan intraclass coefficients ranged from 0,925 to 0,973 for manual measurements and from 0,770 to 0,902 for mKSM method. Despite that the difference between human examiners is smaller than between human examiners and mKSM according to Bland-Altman plots, the scatterplots show a strong correlation between human and automatic measurements. The best results are obtained in intermediate capillary plexus. CONCLUSIONS: Automated determination of the FAZ area in HS-OCTA is feasible and less human-dependent by mKSM even if the image is not perfectly centred or has artefacts. The mKSM processing could contribute to our understanding of the three vascular plexuses.


2021 ◽  
Author(s):  
Fariba Ghassemi ◽  
Vahid Hatami ◽  
Farhad Salari ◽  
Fatemeh Bazvand ◽  
Hadi Shamouli ◽  
...  

Abstract Background: Variations in vessel density (VD) patterns of the macula in children of different ages are unknown.Methods: In this cross-sectional study, subjects with normal eyes aged 3–18 years were enrolled. The macula was scanned by optical coherence tomography angiography (OCTA). Four age groups as under 7 years, 7-10 years, 11-14 years and more than 14 years of age were defined. The influences of age, gender, and body mass index on VD were analyzed.Results: A total of 108 normal eyes from 54 participants with a mean age of 10.9 years were enrolled in the study. At the superficial and deep retina capillary plexus (SCP and DCP) and choriocapillaris (CC), the mean VD of the fovea was 20.10%, 36.99%, and 75.67%, respectively; at parafovea, these measurements were 53.12%, 55.81%, and 69.76%, respectively; and at perifovea, these measures were 51.38%, 52.46%, and 73.47%, respectively. The median foveal avascular zone (FAZ) was 0.28 mm2. No significant differences were found between the superior-hemi and inferior-hemi VD of the studied plexuses. The VD at CC parafovea and perifovea differed significantly between groups. Neither age nor sex affected the VD of macular retina or CC. FAZ areas were different between genders.Conclusions: No difference between eyes and genders in the retina and CC VD of macular area was noted. FAZ area was larger in male. While this study is not a longitudinal study but may give us a hint for the macular vascular development during puberty and clinical applications of OCTA in children.


2021 ◽  
Author(s):  
Erhan Özyol ◽  
Pelin Özyol ◽  
Pınar Günel-Karadeniz

Abstract Background: The vast majority of oxygen required for outer retinal layer, including photoreceptors is provided by choriocapillaris with a little support of deep retinal capillaris. This organization may differ between individuals depending on the variability in photoreceptor density. Based on these, we evaluated the changes and interaction between the retinal capillary networks—organization of retinal microvessels—using optical coherence tomography angiography (OCTA) considering ocular perfusion pressure (OPP) and diurnal variations. Methods: Forty eyes of 40 healthy volunteers formed the sample for this cross-sectional study. Mean arterial pressure (mAP), OPP, and OCTA measures were noted at two different time points on a single day. Results: The mAP, OPP, superficial capillary plexus (SCP), deep capillary plexus (DCP), and choriocapillaris (CC) perfusion values showed no diurnal change (p>0.05). When compared the mAP and OPP with the SCP, DCP, and CC perfusion measurements, there was no significant relation between them (p>0.05). There was a significant moderate positive correlation between DCP and CC values in both morning and afternoon (r=0.422; p=0.007, r=0.493; p=0.001, respectively). Conclusion: The DCP and CC perfusion values show a significant moderate positive correlation. This correlation may suggest the role of DCP in the maintenance of oxygen homeostasis in outer retinal layers.


2017 ◽  
Vol 102 (3) ◽  
pp. 352-357 ◽  
Author(s):  
Jayasree P Venugopal ◽  
Harsha L Rao ◽  
Robert N Weinreb ◽  
Zia S Pradhan ◽  
Srilakshmi Dasari ◽  
...  

AimsTo compare the intrasession repeatability of peripapillary and macular vessel density measurements of optical coherence tomography angiography (OCTA) in normal and glaucoma eyes, and to evaluate the effect of signal strength of OCTA scans on the repeatability.MethodsIn a cross-sectional study, three optic nerve head scans each of 65 eyes (30 normal, 35 glaucoma eyes) and three macular scans each of 69 eyes (35 normal, 34 glaucoma eyes) acquired in the same session with OCTA were analysed. Repeatability was assessed using within-subject coefficient of repeatability (CRw) and variation (CVw). Effect of signal strength index (SSI) on repeatability was evaluated with repeated-measures mixed-effects models.ResultsCRw (%) and CVw (%) of peripapillary measurements in normal eyes ranged between 3.3 and 7.0, and 2.5 and 4.4 respectively, and that in glaucoma eyes between 3.5 and 7.1, and 2.6 and 6.6. For the macular, these measurements ranged between 4.1 and 6.0, and 3.3 and 4.7 in normal eyes and 4.3 and 6.9, and 3.7 and 5.6 in glaucoma eyes. Repeatability estimates of most measurements were similar in normal and glaucoma eyes. Vessel densities of both peripapillary and macular regions significantly increased with increase in SSI of repeat scans (coefficients ranging from 0.15 to 0.38, p<0.01 for all associations).ConclusionsRepeatability estimates of OCTA measured peripapillary and macular vessel densities were similar in normal eyes and eyes with glaucoma. SSI values of the scans had a significant effect on the repeatability of OCTA with the vessel density values increasing in scans with higher SSI values.


2021 ◽  
Vol 8 ◽  
Author(s):  
Xin Wen ◽  
Zijing Li ◽  
Jianhui Xiao ◽  
Xuane Liu ◽  
Yichi Zhang ◽  
...  

Purpose: To determine the association of myopia with peripapillary and macular microvasculature in eyes with type 2 diabetes using optical coherence tomography angiography (OCTA).Methods: Diabetic patients with and without diabetic retinopathy (DR) were recruited and grouped according to myopic status in this cross-sectional study. Axial length, refractive error, and OCTA parameters were measured. OCTA parameters were analyzed with adjustment of confounding factors and further Bonferroni analysis was performed to determine the differences in multiple group comparisons.Results: Compared with the diabetic eyes without myopia, those with myopia had lower rate of DR (21.82 vs. 35.90%, χ2 = 6.190, P = 0.013), longer axial lengths (24.94 ± 0.75 vs. 23.16 ± 0.64, F = 311.055, P &lt; 0.001) and reduced whole vessel density (VD) of optic nerve head (ONH) (45.89 ± 5.76 vs. 49.14 ± 4.33, F = 19.052, P &lt; 0.001), peripapillary VD (48.75 ± 6.56 vs. 50.76 ± 4.51, F = 7.600, P = 0.006), and reduced thickness of the retinal nerve fiber layer (RNFL) (95.50 ± 12.35 vs. 100.67 ± 13.68, F = 5.020, P = 0.026). In eyes without myopia, the superficial vessel density (SVD) (46.58 ± 4.90 vs. 43.01 ± 4.25; 95% CI, 1.80–4.61; P &lt; 0.001), deep vessel density (DVD) (45.64 ± 6.34 vs. 42.15 ± 6.31; 95% CI, 1.07–5.00; P &lt; 0.001), and FD300 area density (50.31 ± 5.74 vs. 44.95 ± 6.96; 95% CI, 2.88–7.27; P &lt; 0.001) were significant reduced in eyes with DR(DR eyes) comparing to those without DR (NoDR eyes). In eyes with myopia, only SVD were significantly reduced in DR eyes comparing to NoDR eyes (41.68 ± 3.34 vs. 45.99 ± 4.17; 95% CI, 1.10–7.22; P = 0.002). In NoDR eyes, both whole VD of ONH and Peripapillary VD demonstrated a significant decrease in eyes with myopia comparing to those without myopia (49.91 ± 4.36 vs. 45.61 ± 6.32; 95% CI, 1.95–6.27; P &lt; 0.001 and 51.36 ± 4.24 vs. 48.52 ± 6.99; 95% CI, 0.56–5.11; P = 0.006, respectively).Conclusions: In diabetic patients, myopic eyes exhibited lower prevalence of DR and thinner thickness of RNFL. The refractive status could possibly impact the retinal microvascular changes from NoDR to DR stage.


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