Optical Coherence Tomography Angiography in Macular Neovascularization: A Comparison Between Different OCTA Devices

Abstract

The purpose of this study is to compare the ability of 3 optical coherence tomography angiography (OCTA) devices to measure lesion area in patients with macular neovascularization (MNV) with type 1, 2 and mixed neovascularization (NV). Methods: OCTA, fluorescein angiography (FA), indocyanine green angiography (ICGA), and structural optical coherence tomography (OCT) were performed. NV lesion area measurements were performed by two graders. Results: Twenty-eight eyes were included: 20 with NV were classified as type 1, 6 as type 2, and 2 as mixed type. AngioVue and Spectralis detected the NV in 26 out of 28 eyes (92.8%). The intraclass correlation coefficient (ICC) between readers for the three different OCTA with the different slabs was high. The NV area was larger in the outer retina to choriocapillaris (ORCC) and choriocapillaris (CC) images for the AngioVue device and the PLEX Elite device compared to avascular images (P < 0.05). The mean values of the NV area were not significantly different among the three instruments (Friedman test, P > 0.05) for the avascular zone (AV), ORCC, and CC images. Median (interquartile range [IQR]) NV were significantly different among avascular images, ORCC images, and CC images of the AngioVue device (P = 0.046), of the Spectralis device (P = 0.015), and the PLEX Elite device (P < 0.001). Conclusions: The ORCC slabs showed the highest detection rate for NV detection independently to the device used, and swept source (SS)-OCTA measurements of ORCC slabs showed the highest detection rate of NVs compared to the spectral domain (SD)-OCTA. Translational Relevance: It is pivotal to realize how much we can rely on OCTA to make a diagnosis of NV.

OCT Angiography Fractal Analysis of Choroidal Neovessels Secondary to Central Serous Chorioretinopathy, in a Caucasian Cohort

“…However, Munk et al revealed that no significant differences exist in terms of CNV detection and VD value computation among different OCT-A modules if the correct OCT-A segmentation is used [ 39 ]. A similar result was reported by Mastropasqua et al [ 40 ], who failed to find any statistical difference among CNV measurements obtained by different OCT-A devices [ 40 ]. By contrast, other authors have reported statistically significant differences between OCT-A devices in terms of CNV area computations, but they argued that such differences may depend on projection artifacts [ 41 ].…”

Brolucizumab Intravitreal Injection in Macular Neovascularization Type 1: VA, SD-OCT, and OCTA Parameter Changes during a 16-Week Follow-Up

“…The NV lesions were manually circumscribed by two independent retinal specialists, and the flow within was calculated as the number of pixels over a non-perfusion threshold, then converted to a comparable mm 2 area value. NV density was considered as the ratio of pixels occupied by flowing vasculature to all pixels included in the analyzed region, as already described [8, 23].…”

“…The chronic exudation from new vessels causing sub/intraretinal and/or sub-retinal pigment epithelium (RPE) fluid formation results in metamorphopsia and visual impairment. Macular atrophy and scarring are the late-stage complications of the disease, leading to irreversible visual loss [1][2][3][4][5][6][7][8].…”

Effect of Pro Re Nata Regimen with Anti-VEGF on Type 3 Macular Neovascularization: Long-Term Outcomes

“…The NV lesions were manually circumscribed by two independent retinal specialists (LT and MCS) and the flow within was calculated as the number of pixels over a nonperfusion threshold and then converted in a comparable mm 2 area value. NV flow area was considered as the ratio of pixels occupied by flowing vasculature to all pixels included in the analyzed region, as already described [14,15]. For NV flow area for statistical analysis, each subject was attributed the mean value between reader 1 and reader 2.…”