Repeatability and reproducibility of optic nerve head perfusion measurements using optical coherence tomography angiography

Chen, Chieh Li; Bojikian, Karine D.; Chen, Xin; Wen, Joanne C; Gupta, Divakar; Zhang, Qinqin; Mudumbai, Raghu C.; Johnstone, Murray; Chen, Philip; Wang, Ke

doi:10.1117/1.jbo.21.6.065002

Cited by 52 publications

(42 citation statements)

References 43 publications

(65 reference statements)

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“…The OMAG technique allows the visualization of microcirculation and is proportional to the blood flow concentration [10]. The results of Chen and coworkers are in line with our findings, since they reported that OMAG has excellent repeatability and reproducibility in identifying and quantifying ONH perfusion in healthy eyes [7,8]. However, those studies were conducted on a very small sample (10 eyes), with all scans performed by the same operator.…”

Section: Discussionsupporting

confidence: 89%

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Functional and Structural Reliability of Optic Nerve Head Measurements in Healthy Eyes by Means of Optical Coherence Tomography Angiography

et al. 2020

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Background and Objectives: the aim of the study was to evaluate the repeatability and reproducibility of optical microangiography (OMAG)-based optical coherence tomography angiography (OCTA) in the optic nerve head (ONH) and radial peripapillary capillary (RPC) perfusion assessment of healthy eyes. Materials and Methods: in this observational study, a total of 40 healthy subjects underwent ONH evaluation, using an OMAG-based OCTA system at baseline (T0), after 30 min (T1), and after 7 days (T2). The main outcome measures were the vessel density (VD) and flux index (FI) of the RPCs, as well as peri-papillary retinal nerve fibre layer (pRNFL) thickness. The analysis was performed by two observers independently. The coefficient of repeatability (CR), within the subject coefficient of variation (CVw) and intrasession correlation coefficient (ICC), to evaluate intrasession repeatability of measurements was calculated for each observer. Results: the high intrasession and intersession repeatability and reproducibility were assessed in the two observers for all three outcome measures. Of note, the CRs for the first and the second observer were 0.011 (95% confidence interval (CI) 0.009–0.014) and 0.016 (95% CI 0.013–0.020) for FI, 0.016 (95% CI 0.013–0.021) and 0.017 (95% CI 0.014–0.021) for VD, and 2.400 (95% CI 1.948–3.092) and 3.732 (95% CI 3.064–4.775) for pRNFL thickness, respectively. The agreement between them was excellent for pRNFL assessment and very good for FI and VD. Conclusion: OCTA has a great potential in the accurate assessment of ONH and peri-papillary microcirculation. It allows for repeated and reproducible measurements without multiple scans-related bias, thus guaranteeing an independent operator analysis with good reproducibility and repeatability.

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Section: Discussionsupporting

confidence: 89%

“…An optical microangiography (OMAG)-based optical coherence tomography angiography (OCTA) system has been recently introduced, and has been shown to have excellent repeatability and reproducibility in the analysis of perfusion features of the ONH in healthy eyes [7,8].…”

Section: Introductionmentioning

confidence: 99%

Functional and Structural Reliability of Optic Nerve Head Measurements in Healthy Eyes by Means of Optical Coherence Tomography Angiography

et al. 2020

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“…Huang and colleagues [20, 21] reported that CV values between visits were 4.3 and 2.7% for the measurement of the peripapillary flow index. Wang and colleagues [22, 23] found that the CV of intravisit and intervisit was < 3.7 and < 5.2%, the ICC was > 96% in the prelaminar, laminar cribrosa and the full ONH measurements. Table 5 summarizes the latest research of the blood flow measurements in the ONH.…”

Section: Discussionmentioning

confidence: 99%

Reliability of Vessel Density Measurements in the Peripapillary Retina and Correlation with Retinal Nerve Fiber Layer Thickness in Healthy Subjects Using Optical Coherence Tomography Angiography

She

Guo

et al. 2018

Ophthalmologica

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Purpose: To evaluate the reliability of vessel density measurements in the peripapillary retina using optical coherence tomography angiography (OCT-A) and to analyze the correlation with retinal nerve fiber layer (RNFL) thickness in healthy subjects. Method: Thirty-five healthy volunteers were recruited in the study. The optic disc region was scanned three times with spectral-domain OCT (SD-OCT) and split-spectrum amplitude decorrelation angiography by two skilled examiners. Vessel density of the peripapillary retina was automatically calculated by the software RTVue-XR (version 2015.1.1.98). The RNFL thickness on the optic nerve head was measured by SD-OCT. The coefficient of variation (CV), coefficient of repeatability, and intraclass correlation coefficients (ICC) were calculated for intraobserver repeatability. The Bland-Altman analysis was used to determine interobserver reproducibility. Correlations between peripapillary retinal vessel density and RNFL thickness were analyzed using a multivariable linear regression. Results: The mean age of the volunteers was 47.0 ± 29.7 years. The intraobserver repeatability in different sectors of the peripapillary retina was good with a high coefficient of repeatability, low CV (< 0.2%), and high ICC (0.847–0.952). The interobserver reproducibility was also good in different sectors, but should be interpreted with caution due to the difference bias caused by different observers in some quadrants. There was a significant positive correlation between vessel density and RNFL thickness; optic disc rim area and disc area were negatively related to vessel density (p = 0.008 and p = 0.001, respectively). Conclusion: Vessel density measurements showed good repeatability and reproducibility by OCT-A in the peripapillary retina, the vessel density was positively related to RNFL thickness and negatively related to optic disc area and rim area.

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“…Rather than using the full thickness optic nerve head slab, Chen et al isolated the pre-laminar layer to report perfusion differences between glaucoma and normal eyes, with good repeatability and reproducibility (Chen C 2016, Chen C 2016). In addition, Chen et al introduced two new indices, termed flux and normalized flux, and demonstrated good repeatability and reproducibility.…”

Section: Review Of Clinical Studies Utilizing Octamentioning

confidence: 99%

Optical coherence tomography angiography: A comprehensive review of current methods and clinical applications

Kashani

Chen

Gahm

et al. 2017

Progress in Retinal and Eye Research

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561

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OCT has revolutionized the practice of ophthalmology over the past 10 to 20 years. Advances in OCT technology have allowed for the creation of novel OCT-based methods. OCT-Angiography (OCTA) is one such method that has rapidly gained clinical acceptance since it was approved by the FDA in late 2016. OCTA images are based on the variable backscattering of light from the vascular and neurosensory tissue in the retina. Since the intensity and phase of backscattered light from retinal tissue varies based on the intrinsic movement of the tissue (e.g. red blood cells are moving, but neurosensory tissue is static), OCTA images are essentially motion-contrast images. This motion-contrast imaging provides reliable, high resolution, and non-invasive images of the retinal vasculature in an efficient manner. In many cases, these images are approaching histology level resolution. This unprecedented resolution coupled with the simple, fast and non-invasive imaging platform have allowed a host of basic and clinical research applications. OCTA has been shown to demonstrate many important clinical findings including areas of macular telangiectasia, impaired perfusion, microaneurysms, capillary remodeling, some types of intraretinal fluid, and neovascularization among many others. More importantly, OCTA provides depth-resolved information that has never before been available. Correspondingly, OCTA has been used to evaluate a spectrum of retinal vascular diseases including diabetic retinopathy (DR), retinal venous occlusion (RVO), uveitis, retinal arterial occlusion, and age-related macular degeneration among others. In this review, we will discuss the methods used to create OCTA images, the practical applications of OCTA in light of invasive dye-imaging studies (e.g. fluorescein angiography) and review clinical studies demonstrating the utility of OCTA for research and clinical practice.

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Repeatability and reproducibility of optic nerve head perfusion measurements using optical coherence tomography angiography

Cited by 52 publications

References 43 publications

Functional and Structural Reliability of Optic Nerve Head Measurements in Healthy Eyes by Means of Optical Coherence Tomography Angiography

Functional and Structural Reliability of Optic Nerve Head Measurements in Healthy Eyes by Means of Optical Coherence Tomography Angiography

Reliability of Vessel Density Measurements in the Peripapillary Retina and Correlation with Retinal Nerve Fiber Layer Thickness in Healthy Subjects Using Optical Coherence Tomography Angiography

Optical coherence tomography angiography: A comprehensive review of current methods and clinical applications

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