Effect of vessel enhancement filters on the repeatability of measurements obtained from widefield swept-source optical coherence tomography angiography

Hong, Jimmy; Ke, Mengyuan; Tan, Bingyao; Lau, Amanda; Wong, Damon Wing Kee; Yao, Xinwen; Liu, Xinyu; Schmetterer, Leopold; Chua, Jacqueline

doi:10.1038/s41598-020-79281-3

Cited by 9 publications

(12 citation statements)

References 49 publications

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“…A list of OCTA metrics (Figure S2 ), including retinal capillary density at the superficial and deep capillary plexus, choriocapillaris flow deficits density and foveal avascular zone (FAZ) area, can be calculated automatically (MATLAB; The MathWorks, Inc., Natick, MA; Version R2020b). 38 , 39 Capillary density was defined as the total vessel length (in mm) per total imaged area (in mm 2 ). Choriocapillaris flow deficits density was defined as the percentage of flow deficits area per total imaged area.…”

Section: Methodsmentioning

confidence: 99%

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Relationship of Quantitative Retinal Capillary Network and Myocardial Remodeling in Systemic Hypertension

Chua

Sim

et al. 2022

JAHA

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Background This study examined the associations between quantitative optical coherence tomography angiography (OCTA) parameters and myocardial abnormalities as documented on cardiovascular magnetic resonance imaging in patients with systemic hypertension. Methods and Results We conducted a cross‐sectional study of 118 adults with hypertension (197 eyes). Patients underwent cardiovascular magnetic resonance imaging and OCTA (PLEX Elite 9000, Carl Zeiss Meditec). Associations between OCTA parameters (superficial and deep retinal capillary density) and adverse cardiac remodeling (left ventricular mass, remodeling index, interstitial fibrosis, global longitudinal strain, and presence of left ventricular hypertrophy) were studied using multivariable linear regression analysis with generalized estimating equations. Of the 118 patients with hypertension enrolled (65% men; median [interquartile range] age, 59 [13] years), 29% had left ventricular hypertrophy. After adjusting for age, sex, systolic blood pressure, diabetes, and signal strength of OCTA scans, patients with lower superficial capillary density had significantly higher left ventricular mass (β=−0.150; 95% CI, −0.290 to −0.010), higher interstitial volume (β=−0.270; 95% CI, −0.535 to −0.0015), and worse global longitudinal strain (β=−0.109; 95% CI, −0.187 to −0.032). Lower superficial capillary density was found in patients with hypertension with replacement fibrosis versus no replacement fibrosis (16.53±0.64 mm ‐1 versus 16.96±0.64 mm ‐1 ; P =0.003). Conclusions We showed significant correlations between retinal capillary density and adverse cardiac remodeling markers in patients with hypertension, supporting the notion that the OCTA could provide a non‐invasive index of microcirculation alteration for vascular risk stratification in people with hypertension.

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Section: Methodsmentioning

confidence: 99%

“…We showed previously that the superficial capillary density (intraclass correlation=0.85), deep capillary density (intraclass correlation=0.82), and choriocapillaris flow deficits density (intraclass correlation=0.87), exhibited good reproducibility. 23 , 38 The FAZ was manually outlined, and the area was computed in mm 2 .…”

Section: Methodsmentioning

confidence: 99%

Relationship of Quantitative Retinal Capillary Network and Myocardial Remodeling in Systemic Hypertension

Chua

Sim

et al. 2022

JAHA

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“…Second, the ROI tool in ImageJ was used to select the target regions for analysis, which included the macular region (a 6 mm diameter circle centered at the fovea), the peripapillary area (a 500 μm-wide ring of 2 mm inner diameter and 3 mm outer diameter centered at the optic nerve head), and the whole field of view (whole FOV) with optic papilla area (a 3 mm diameter circle) and the image label “PLEX® Elite” excluded (cropped). Next, images were binarized using commands “Huang's fuzzy” for SVP and DVP slabs or “Phansalkar method” with radius = 15 for CC slabs ( 27 ). Finally, the fractional area of vessels within the ROI (or the perfusion density) was measured.…”

Section: Methodsmentioning

confidence: 99%

“…All images were checked independently by two trained graders (Ye and Zhang). The OCTA slabs were processed and analyzed according to the procedure used in previous works (16,(27)(28)(29)(30). Each OCTA slab was loaded into ImageJ (National Institutes of Health, Bethesda, Maryland, USA; https://imagej.net/Welcome) to measure FAZ, VLD or VPD, and FV parameters as follows.…”

Section: Image Processing and Measurements Of The Parametersmentioning

confidence: 99%

Microvasculature Features of Vogt-Koyanagi-Harada Disease Revealed by Widefield Swept-Source Optical Coherence Tomography Angiography

Zhang

Xiao

et al. 2021

Front. Med.

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Background: Vogt-Koyanagi-Harada (VKH) disease is a multisystem autoimmune disorder which could induce bilateral panuveitis involving the posterior pole and peripheral fundus. Optical coherence tomography angiography (OCTA) provides several advantages over traditional fluorescence angiography for revealing pathological abnormalities of the retinal vasculature. Until recently, however, the OCTA field of view (FOV) was limited to 6 × 6 mm2 scans.Purpose: This study examined retinal vasculature and choriocapillaris abnormalities across multiple regions of the retina (15 × 9 mm2 wide field, macular, peripapillary regions) among acute and convalescent VKH patients using a novel widefield swept-source OCTA (WSS-OCTA) device and assessed correlations between imaging features and best-corrected visual acuity (BCVA).Methods: Twenty eyes of 13 VHK disease patients in the acute phase, 30 eyes of 17 patients in the convalescent phase, and 30 eyes of 15 healthy controls (HCs) were included in this study. Vascular length density (VLD) in superficial and deep vascular plexuses (SVP, DVP), vascular perfusion density (VPD) in SVP, DVP, and choriocapillaris (CC), and flow voids (FV) in CC were measured across multiple retinal regions via WSS-OCTA (PLEX Elite 9000, Carl Zeiss Meditec Inc., USA) using the 15 × 9 mm2 scan pattern centered on the fovea and quantified by ImageJ.Results: Compared to HCs, acute phase VKH patients exhibited significantly reduced SVP-VLD, SVP-VPD, and CC-VPD across multiple retinal regions (all p < 0.01). Notably, the FV area was more extensive in VKH patients, especially those in the acute phase (p < 0.01). These changes were reversed in the convalescent phase. Stepwise multiple linear regression analysis demonstrated that macular DVP-VLD and macular CC-VPD were the best predictive factors for BCVA in the acute and convalescent VKH groups.Conclusion: The wider field of SS-OCAT provides more comprehensive and detailed images of the microvasculature abnormalities characterizing VKH disease. The quantifiable and layer-specific information from OCTA allows for the identification of sensitive and specific imaging markers for prognosis and treatment guidance, highlighting WSS-OCTA as a promising modality for the clinical management of VKH disease.

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“…Even though previous studies focused on the repeatability of quantitative metrics other than FD using widefield SS-OCTA, we can compare our results to them [ 36 , 37 ]. J Hong et al investigated the inter-visit repeatability of 15 × 9 mm 2 SS-OCTA and they demonstrated highly repeatable measurements of retinal vascular metrics [ 36 ]. They also showed that ICC values in the DCP were generally lower than those of the SCP.…”

Section: Discussionmentioning

confidence: 99%

Repeatability and Reproducibility of Retinal Fractal Dimension Measured with Swept-Source Optical Coherence Tomography Angiography in Healthy Eyes: A Proof-of-Concept Study

et al. 2022

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The retinal vascular network fractal dimension (FD) could be a promising imaging biomarker. Our objective was to evaluate its repeatability and reproducibility in healthy eyes. A cross-sectional study was undertaken with young, healthy volunteers who had no reported cardiac risk factors or ocular disease history. For each participant, three SS-OCTA images (12 × 12 mm) were acquired using the Plex Elite 9000 (Carl Zeiss Meditec AG, Jena, Germany) by two ophthalmologists. Automated segmentation was obtained from both the superficial and deep capillary plexuses. FD was estimated by box counting. The intraclass correlation coefficients (ICC) were used as measures for repeatability and reproducibility. A total of 43 eyes of healthy volunteers were included. The mean ± standard deviation (SD) age was 30 ± 6.2 years. The results show good repeatability. The ICC was 0.722 (95% CI, 0.541–0.839) in the superficial capillary plexus and 0.828 (95% CI, 0.705–0.903) in the deep capillary plexus. For reproducibility, the ICC was 0.651 (95% CI, 0.439–0.795) and 0.363 (95% CI, 0.073–0.596) at the superficial and deep capillary plexus, respectively. In this study, the FD of the vascular network measured via SS-OCTA showed good repeatability and reproducibility in healthy participants.

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Effect of vessel enhancement filters on the repeatability of measurements obtained from widefield swept-source optical coherence tomography angiography

Cited by 9 publications

References 49 publications

Relationship of Quantitative Retinal Capillary Network and Myocardial Remodeling in Systemic Hypertension

Relationship of Quantitative Retinal Capillary Network and Myocardial Remodeling in Systemic Hypertension

Microvasculature Features of Vogt-Koyanagi-Harada Disease Revealed by Widefield Swept-Source Optical Coherence Tomography Angiography

Repeatability and Reproducibility of Retinal Fractal Dimension Measured with Swept-Source Optical Coherence Tomography Angiography in Healthy Eyes: A Proof-of-Concept Study

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