Optical coherence tomography angiography image quality assessment at varying retinal expertise levels

Woetzel, Anne K.; Lauermann, Jost Lennart; Kreitz, Kiana; Alnawaiseh, Maged; Clemens, Christoph R.; Eter, Nicole; Alten, Florian

doi:10.1016/j.joco.2018.12.002

Cited by 11 publications

(11 citation statements)

References 22 publications

(33 reference statements)

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“…Despite comparable results concerning the total frequency of motion artifacts in both groups, it is noteworthy, that motion artifacts were also clearly higher in our control group compared to the literature 18,22,27 . One possible explanation could be the experience of the user who took the OCTA images.…”

Section: Discussioncontrasting

confidence: 85%

“…We assume that at most centers, clinical practice is that OCT and OCTA images are not taken by ophthalmologists, but by properly trained non-medical staff. Woetzel et al discussed the influence of different expertise levels in OCTA image quality assessment 22 . They concluded that trained non-ophthalmologic assessors could perform OCTA image quality assessment in a sufficient manner.…”

Section: Discussionmentioning

confidence: 99%

“…Parameters for the evaluation of OCTA image quality were the expression of specific motion artifacts, i.e., banding/quilting, blink lines, displacement, stretching, and vessel doubling, following the OCTA motion artifact score (MAS, Supplemental Table S1 ) that has been previously described in detail (Fig. 1 ) 18 , 22 . Since the comparability of MAS is enhanced by centration of the OCTA image on the fovea and clear optic media, these additional parameters, centration (1: not perfectly centered, 2: perfectly centered) and vitreous opacities (1: present, 2: not present) were also assessed by the two readers.…”

Section: Methodsmentioning

confidence: 99%

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Applicability of optical coherence tomography angiography (OCTA) imaging in Parkinson’s disease

Lauermann

Sochurek

Plöttner

et al. 2021

Sci Rep

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To evaluate the significance of motion artifacts in optical coherence tomography angiography (OCTA) images of patients with Parkinson’s disease (PD) and healthy controls. In this prospective, cross-sectional study subjects with medicated PD (ON) and healthy, age- and gender-matched volunteers were recruited. Participants underwent specific ophthalmological examinations, including OCTA. Angiograms of the superficial retinal capillary plexus were evaluated for the type and frequency of artifacts using a validated motion artifact score (MAS). A total of 30 PD patients (60 eyes), average disease duration of 9.61 ± 5.55 years, and 30 matched, healthy controls (60 eyes) were recruited. Twenty percent of all eyes had an eye disease, unknown to the participant, with a significant impact on OCTA results. After cleansing the dataset by excluding subjects with confounding ocular comorbidities 42 eyes of 28 PD patients and 53 eyes of 29 healthy controls were further evaluated. Overall MAS and all five subtypes of motion artifacts were comparable without significant differences between groups. OCTA can be used in treated PD patients (ON) without a significant increase in motion artifacts. Nevertheless, special attention should be paid to image quality during the acquisition of OCTA data, for which an experienced OCTA operator is useful.

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Section: Discussioncontrasting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Applicability of optical coherence tomography angiography (OCTA) imaging in Parkinson’s disease

Lauermann

Sochurek

Plöttner

et al. 2021

Sci Rep

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“…Also, scans with increased pathology are more likely to have disagreement between graders. 25 Additionally, as none of the factors studied was modifiable, the study was unable to identify additional ways to improve scan quality.…”

Section: Discussionmentioning

confidence: 98%

Optical Coherence Tomography Angiography Quality Across Three Multicenter Clinical Studies of Diabetic Retinopathy

Lujan¹,

Calhoun

Glassman

et al. 2021

Trans. Vis. Sci. Tech.

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Purpose To explore optical coherence tomography angiography (OCTA) quality and associated factors in multicenter clinical studies. Methods OCTA scans were obtained from participants with diabetic retinopathy from three DRCR Retina Network clinical studies using the Optovue AngioVue and ZEISS AngioPlex. Macular (3 × 3 mm and 6 × 6 mm) and optic nerve scans were captured. Quality was assessed by the Casey Reading Center. Scans were considered “poor” if the signal strength index (SSI) was less than 55 (AngioVue) or 7 (AngioPlex) or if excess motion, media opacities, beam defocus, incorrect axial position, or other artifacts were present. Results Included were 7539 scans from 787 eyes (461 participants). Sixty-one percent of scans were considered “good” (n = 4630). Of the 3 × 3-mm (n = 2294), 6 × 6-mm (n = 2705), and optic nerve scans (n = 2540), 62%, 63%, and 59%, respectively, were good. Differences in percentage of good scans by machine were not identified (61% of 6216 for the AngioVue and 63% of 1323 for the AngioPlex). The primary reason for poor scans was low SSI for the AngioVue (67%) and excess motion for the AngioPlex (47%). Good scans were associated with younger age (60 ± 12 years vs. 65 ± 11 years; P < 0.001), male gender (64% of males had good scans vs. 57% female; P = 0.007), and better visual acuity (ETDRS letter score 86.5 ± 6.4 [approximate Snellen equivalent 20/20] vs. 81.6 ± 9.7 [approximate Snellen equivalent 20/25]; P < 0.001). Conclusions Scan quality or analysis must be improved for OCTA metrics to be used as outcomes in future research. Translational Relevance Clinicians and researchers should be aware that poor SSI and artifacts are common issues for OCTA images.

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“…The quality of OCTA images is crucial for the accurate interpretation of morphological changes in the retinal vasculature and also affects the quantitative analysis results; therefore, improvement of image quality has become a hot research topic [6,7]. Several protocols have been used to evaluate the image quality of OCTA, including objective evaluations, such as single strength, contrast-to-noise ratio (CNR), and peak signal-to-noise ratio (PSNR), and subjective retinal expert evaluation [8][9][10][11]. Of these, the PSNR is one of the most outstanding and widely used objective parameter of image quality evaluation between different images [11,12].…”

Section: Introductionmentioning

confidence: 99%

Enhanced Visualization of Retinal Microvasculature via Deep Learning on OCTA Image Quality

Hua

et al. 2021

Disease Markers

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Purpose. To investigate the impact of denoising on the qualitative and quantitative parameters of optical coherence tomography angiography (OCTA) images of the optic nerve and macular area. Methods. OCTA images of the optic nerve and macular area were obtained using a Canon-HS100 OCT device for 48 participants (48 eyes). Multiple image averaging (MIA) and denoising techniques were used to improve the quality of the OCTA images. The peak signal-to-noise ratio (PSNR) as an image quality parameter and vessel density (VD) as a quantitative parameter were obtained from single-scan, MIA, and denoised OCTA images. The parameters were compared, and the correlation was analyzed between different imaging protocols. Results. In the optic nerve area, there were significant differences in the PSNR and VD in all measured regions between the three groups ( P < 0.0001 ). The PSNR of the denoised group was significantly higher than that of the other two groups ( P < 0.0001 ). The VD in the denoised group was significantly lower than that in the single-scan group in all measured regions ( P < 0.0001 ). In the macular area, there were significant differences in the PSNR and VD in all measured regions among the three groups. The PSNR of the denoised group was significantly higher than that of the other two groups ( P < 0.0001 ). The VD in the denoised group was significantly lower than that in the single-scan group in all measured regions. The VD around the optic nerve in the denoised group was correlated with that in the single-scan group ( R = 0.9403 , P < 0.0001 ), but the VD in the MIA group was not correlated with that in the single-scan group ( R = 0.2505 , P = 0.2076 ). The VD around the fovea in the denoised and MIA images was correlated with that in the single-scan group ( R = 0.7377 , P < 0.0001 ; R = 0.7005 , P = 0.0004 , respectively). Conclusion. Denoising could provide an easy and quick way to improve image quality parameters, such as PSNR. It shows great potential in improving the sensitivity of OCTA images as retinal disease markers.

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Optical coherence tomography angiography image quality assessment at varying retinal expertise levels

Cited by 11 publications

References 22 publications

Applicability of optical coherence tomography angiography (OCTA) imaging in Parkinson’s disease

Applicability of optical coherence tomography angiography (OCTA) imaging in Parkinson’s disease

Optical Coherence Tomography Angiography Quality Across Three Multicenter Clinical Studies of Diabetic Retinopathy

Enhanced Visualization of Retinal Microvasculature via Deep Learning on OCTA Image Quality

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