Prevalences of segmentation errors and motion artifacts in OCT-angiography differ among retinal diseases

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

doi:10.1007/s00417-018-4053-2

Cited by 76 publications

(77 citation statements)

References 35 publications

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“…Our inter-observer agreement is similar to that reported by Munk et al 16 (κ =0.52) for superficial capillary plexus on the Optovue device. Lauermann et al 17 reported 89% agreement in their MAS and SAS grading between two graders, whereas we had only 74.5% agreement between the three graders and 67%-83% agreement between two graders (Tables S1-S3).…”

Section: F I G U R E 3 Receiver Operating Characteristic Curves Showicontrasting

confidence: 55%

“…Therefore, clinical trials of retinal vascular disease that examine OCTA parameters as secondary endpoints need to anticipate high rates (60%‐70%) of failure to acquire acceptable image for quantitative analysis. A previous study suggested that poor visual acuity and unstable fixation contribute to motion artefact and segmentation error . We showed that among patient factors (age and sex) and ocular factors (visual acuity, eye pathology and macular status) decreased visual acuity was the only significant predictor for unacceptable OCTA image quality.…”

Section: Discussionmentioning

confidence: 49%

“…A previous study suggested that poor visual acuity and unstable fixation contribute to motion artefact and segmentation error. 17 We showed that among patient factors (age and sex) and ocular factors (visual acuity, eye pathology and macular status) decreased visual acuity was the only significant predictor for unacceptable OCTA image quality.…”

Section: Factors Affecting Octa Image Qualitymentioning

confidence: 78%

“…Munk et al reported a subjective grading system to compare the image quality between four commercially available OCTA devices. Lauermann et al also recently described a motion artefacts score (MAS) and segmentation accuracy score (SAS) to compare the frequency of motion artefacts and segmentation errors between healthy subjects and patients with retinal diseases. Cardoso et al graded the OCTA images into adequate, fair and poor depending on the degree of confidence in reading the photographic features as a part of their study to evaluate the utility of OCTA in RVO.…”

Section: Discussionmentioning

confidence: 99%

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Clinical validation of the RTVue optical coherence tomography angiography image quality indicators

Ali

Sampson

Yong

et al. 2019

Clinical Exper Ophthalmology

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Importance All automated image quality indicators for en face optical coherence tomography angiography (OCTA) images require gold standard validation for determining optimum thresholds. Background A manual grading system (gold standard) for OCTA images was validated and compared to two automated image quality indicators: signal strength index (SSI) and scan quality index (SQI) generated by different software versions of the Optovue OCTA device. Design Retrospective cross‐sectional study. Participants A total of 52 eyes of 52 healthy individual and 77 eyes of 51 patients with retinal vascular diseases. Methods A total of 129 OCTA images of the superficial vascular plexus were graded manually by three independent examiners. Each image was assigned grades 1 to 4 (1‐2, unacceptable; 3‐4, acceptable) masked to the software‐generated quality indicators. Main Outcome Measures Inter‐grader agreement and comparison of the utility of SSI and SQI in discriminating between acceptable and unacceptable OCTA images. Results There was a substantial agreement between the three graders (κ = 0.63). Mean SSI and SQI was significantly different between acceptable and unacceptable images (P < .001). SQI outperformed SSI in separating acceptable from unacceptable images (areas under the receiver operating characteristic curve: 0.87 vs 0.80) and the optimum cut‐off was ≥7 for SQI and ≥70 for SSI for acceptable images. Up to 30% of images with quality indicators reaching the optimum SQI and SSI cut‐off thresholds still had unacceptable quality on manual grading. Unacceptable images were found in 33% and 66% of healthy and diseased eyes, respectively. Conclusions and Relevance SQI is closely related to manual grading but we caution reliance on the optimized threshold to determine image quality. SQI is superior to SSI in discriminating between acceptable and unacceptable images.

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Section: F I G U R E 3 Receiver Operating Characteristic Curves Showicontrasting

confidence: 55%

Section: Discussionmentioning

confidence: 49%

Section: Factors Affecting Octa Image Qualitymentioning

confidence: 78%

Section: Discussionmentioning

confidence: 99%

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Clinical validation of the RTVue optical coherence tomography angiography image quality indicators

Ali

Sampson

Yong

et al. 2019

Clinical Exper Ophthalmology

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“…Only OCTA scans with a signal strength ≥7, centred on the fovea, and the absence of motion as well as projection artefacts were considered (Lauermann et al. 2018b; Spaide et al. ).…”

Section: Methodsmentioning

confidence: 99%

Evaluating diurnal changes in choroidal sublayer perfusion using optical coherence tomography angiography

Siegfried

Rommel

Rothe

et al. 2019

Acta Ophthalmologica

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Purpose: To investigate diurnal changes of choroidal sublayer perfusion in normal eyes and to identify influencing factors using optical coherence tomography angiography (OCTA). Methods: A prospective study was conducted on healthy volunteers, each of whom underwent repeated measurements of subfoveal choroidal thickness (SFCT) via enhanced depth imaging (EDI) optical coherence tomography (OCT) as well as perfusion of choroidal vascular sublayers using OCTA at 7 a.m., 12 p.m., 4 p.m. and 8 p.m. Possible interactions between diurnal variations and other factors, such as mean arterial pressure (MAP), gender and age, were evaluated. Results: A total of 22 eyes from 22 participants were analysed. Mean age of participants was 56 years. A significant pattern of diurnal variation was observed for SFCT (p < 0.001) as well as perfusion of Sattler's layer (SLP; p = 0.009) and Haller's layer (HLP; p = 0.003). SFCT demonstrated a linear decrease, being thicker in the morning (348 lm) and thinner in the evening (310 lm). Both, SLP and HLP showed a quadratic relation to time of day, increasing from morning (64% and 76%) to afternoon (66% and 77%), before decreasing again in the evening (64% and 76%). HLP changes were significantly associated with fluctuations of MAP (B = 0.0007; CI 0.0001-0.0014; p = 0.047). No significant differences with regard to gender were detectable. However, older participants (≥60 years) had fewer diurnal changes (p = 0.042). Conclusion: Optical coherence tomography angiography-based analysis of choroidal sublayer perfusion demonstrated significant diurnal variations. Therefore, it is important to account for time of day, when comparing longitudinal OCTA data.

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Prevalence and Severity of Artifacts in Optical Coherence Tomographic Angiograms

et al. 2020

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Prevalences of segmentation errors and motion artifacts in OCT-angiography differ among retinal diseases

Abstract: Prior to both qualitative and quantitative analysis, OCT-A images must be carefully reviewed as motion artifacts and segmentation errors in current OCT-A technology are frequent particularly in pathologically altered maculae.

Cited by 76 publications

References 35 publications

Clinical validation of the RTVue optical coherence tomography angiography image quality indicators

Clinical validation of the RTVue optical coherence tomography angiography image quality indicators

Evaluating diurnal changes in choroidal sublayer perfusion using optical coherence tomography angiography

Prevalence and Severity of Artifacts in Optical Coherence Tomographic Angiograms

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