Comparison of retina specialist preferences regarding spectral-domain and swept-source optical coherence tomography angiography

Abstract

PurposeThe aim of this study was to compare physician preferences regarding the commercially available spectral-domain (SD) optical coherence tomography angiography (OCTA) and swept-source (SS) OCTA prototype device.DesignComparative analysis of diagnostic instruments was performed.Patients and methodsSubjects at the University of Washington Eye Institute and Harborview Medical Center were prospectively recruited and imaged with the Zeiss SD OCTA (HD-5000, Angioplex) and Zeiss SS OCTA (Plex Elite, Everest) devices on the same day. The study included 10 eyes from 10 subjects diagnosed with a retinal/choroidal disease. Deidentified images were compiled into a survey and sent to retina specialists in various countries. The survey presented masked SD and SS images of each eye for each retinal sublayer side by side. Respondents were asked about their image preference and impact on clinical management. A priori and post hoc preferences for SD vs SS were collected.ResultsFifty-four retina specialists responded to the survey. Median years in practice was 3.00 (interquartile range [IQR] 1.50–17.00). At baseline, 23 (48%) physicians owned an OCTA machine. The majority of physician responses showed a preference for the SS over SD OCTA, independent of the retinal pathology shown (n=454 overall responses, 74%). Nevertheless, the majority indicated that both SD and SS would be equally valuable in informing clinical decisions (n=374 overall responses, 61%).ConclusionThese findings indicate that the majority of retina specialists surveyed prefer SS over SD OCTA based on image quality, regardless of the retinal pathology shown. Regarding the clinical utility of each modality, the majority of physicians perceive SD and SS as equally effective.

Optical Coherence Tomography Angiography Offers New Insights into Choriocapillaris Perfusion

“…Interestingly, retina specialists generally seem to prefer SS-OCT to SD-OCT, as recently reported using the example of the two Zeiss OCTA devices Angioplex and PLEX Elite 9000. Although most physicians preferred the SS-OCTA to the SD-OCTA device, 61% of the participants stated that both devices were equally valuable [16]. So far, the high cost of the SS-OCT technology has presumably limited widespread commercial and clinical acceptance of this method to date.…”

Choroidal vascularity changes in idiopathic central serous chorioretinopathy after half-fluence photodynamic therapy

“…Chan et al [ 17 ] revealed a greater choriocapillaris width in CSC eyes than in unaffected fellow eyes using OCT angiography. However, OCT angiography has limitations in the evaluation of Sattler’s and Haller’ layers because of backscattering of light from the RPE–Bruch membrane complex, flow projection artifacts caused by the choriocapillaris, and interference fringe washout caused by high flow in the larger choroidal vessels [ 18 , 19 ].…”

The Diagnostic Capability of Swept Source OCT Angiography in Treatment-Naive Exudative Neovascular Age-Related Macular Degeneration

“…e recent implementation of OCTA in clinical routine enabled new possibilities for the detection, analyzation, and observation of MNV in AMD [14][15][16]. At the moment, commercially available for a few years, swept source-OCTA (SS-OCTA) is the most promising OCTA technology with a longer wavelength and greater signal-to-noise ratio at greater imaging depths, resulting in deeper tissue penetration, better visualization of microvascular structures, and higher diagnostic accuracy compared to spectral domain-OCTA (SD-OCTA) [17][18][19][20][21].…”