Segmentation errors and motion artifacts in OCT-A associated with epiretinal membranes

Bontzos, Georgios; Kabanarou, Stamatina Α.; Garnavou-Xirou, Christina; Gkizis, Ilias; Kontou, Evgenia; Triantafyllou, Dionysios; Xirou, Tina

doi:10.1016/j.jcjo.2019.12.007

Cited by 13 publications

(9 citation statements)

References 32 publications

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“…OCTA image quality tends to be inaccurate in patients with severe retinal degeneration due to ERM [6], and ERM may disrupt the retina's layered structure; hence segmentation errors may exist in FAZ analysis [18]. According to Bontzos et al [20], the iERM period is significantly related to segmentation errors in OCTA. As such, there may be increased measurement errors in the OCTA image immediate to surgery; therefore, in this study, to overcome the inherent limitation of OCTA analysis, OCTA images taken 3 months before surgery, expecting relatively little disruption of the retinal layer, were also analyzed.…”

Section: Discussionmentioning

confidence: 99%

Effect of Foveal Pit Restoration in Foveal Avascular Zone after Surgery for Idiopathic Epiretinal Membrane

Bae

Ryoo

2022

Korean J Ophthalmol

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Purpose: To investigate the relationship between ophthalmic parameters—including optical coherence tomography (OCT) and OCT angiography findings—and foveal pit restoration in eyes that had undergone vitrectomy for idiopathic epiretinal membrane (iERM) removal.Methods: This study retrospectively analyzed data of patients who underwent pars planar vitrectomy for the removal of epirentinal membrane. Only eyes with iERM above stage 2 with a follow-up over 6 months were included. Baseline data and changes in ophthalmic parameters were analyzed from 3 months before to 12 months after surgery. Additionally, we stratified iERM patients into two groups (foveal pit restoration and no restoration group). Longitudinal comparison analyses between the two groups were done in best-corrected visual acuity (BCVA), central foveal thickness (CFT) and foveal avascular zone (FAZ) areas measurements using swept-source OCT and OCT angiography.Results: Forty-three patients with a mean age of 75 ± 5 years were enrolled. After surgery, BCVA, FAZ, and CFT showed improvements over time (all p < 0.002). Thirty-one patients were designated into the foveal pit restoration (R) group and 12 patients into the no restoration (NR) group. Differences in BCVA and FAZ area in both groups existed up to 6 months. However, BCVA improved and FAZ expanded (R, 0.20 ± 0.05 vs. NR, 0.18 ± 0.04) in both groups showing no statistical difference 12 months postsurgery. The CFT decreased in both groups, but the R group was thinner at every point compared to the NR group (all p < 0.05).Conclusions: The removal of epirentinal membrane in pars planar vitrectomy significantly improves BCVA, decreases the CFT and expands the FAZ. Foveal pit restoration improves BCVA, CFT, and FAZ area possibly at a faster rate in the early months but long-term improvements could be achieved regardless of the status of foveal pit restoration.

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Section: Discussionmentioning

confidence: 99%

Effect of Foveal Pit Restoration in Foveal Avascular Zone after Surgery for Idiopathic Epiretinal Membrane

Bae

Ryoo

2022

Korean J Ophthalmol

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“…Low-quality OCTA images, severe artifacts due to poor fixation, or cases of failed automatic layer segmentation were excluded from analysis. Images were reviewed by two investigators (DB and MD) for segmentation accuracy, as Bontzos et al found a 14-fold increased risk of motion artifact occurrence in the ERM patients, correlated with the disease severity, mostly in interior plexiform and in the ILM layers [9]. High myopic or hyperopic eyes were excluded to avoid bias in the vascular density measurement.…”

Section: Methodsmentioning

confidence: 99%

The Role of OCT Angiography in the Assessment of Epiretinal Macular Membrane

Bacherini

Dragotto

Caporossi

et al. 2021

Journal of Ophthalmology

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Background. The aim of this observational study is to assess pre- and postoperative retinochoroidal vascular changes in patients undergoing epiretinal macular membrane (ERM) surgery by using optical coherence tomography angiography (OCTA). Materials and Methods. 23 eyes affected by ERM and those which underwent phacovitrectomy associated with ERM peeling were enrolled. They were evaluated using structural OCT and OCTA before surgery and at 1, 3, and 6 months postoperatively. Results. We found a statistically significant ( p < 0.05) increase in the superficial capillary plexus vessel density (VD) from baseline to the 6-month follow-up. We observed a large increase in both the perfusion density (PD) and the VD of the deep capillary plexus between baseline and the 6-month follow-up ( p < 0.001). A significant decrease in the VD and PD of the choriocapillaris (CC) from baseline to the 1st month and a significant increase in CC perfusion density at the 6-month follow-up compared to the preoperative value were revealed. The FAZ area and perimeter after surgery significantly increased during the follow-up ( p < 0.001) at baseline retinal and choroidal plexi with a lower PD or VD correlated with worse visual acuity ( p < 0.05 for all plexi). At baseline and at the 1-month follow-up, a significant correlation was found with the FAZ area and the FAZ perimeter: a smaller FAZ area or a smaller FAZ perimeter was correlated to a lower visual acuity. Before surgery, negative correlations ( p < 0.05) were found between the Govetto ERM stages and perfusion density of the SCP and the DCP and between the Govetto stages and vessel density of the DCP. Conclusions. In our study, OCTA detected vascular alterations induced by the presence of the ERM, allowing several correlations with functional data. In these patients, OCTA may be useful to add new potential surgical prognostic factors.

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“…The tangential and anteroposterior forces of the ERM typically lead to a thickening of the macular with displacement of the retinal vessels, leading to a decreased size of the foveal avascular zone (FAZ) and a reduced parafoveal vessel density (VD) [31,32]. However, vessel analyses of retinal substructures especially are quite different among studies, probably due to the error-prone retinal layer segmentation in ERM patients [33]. After ERM-ILM peeling, the parafoveal VD seems to increase, whereas the foveal density decreases due to reorganization and enlargement of the FAZ [17,34].…”

Section: Discussionmentioning

confidence: 99%

Influences of Central Bouquet Alterations on the Visual Outcome in Eyes Receiving Epiretinal Membrane Surgery

et al. 2021

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Background: Previous studies have shown that epiretinal membranes (ERMs) may be associated with abnormal outer retinal anatomy. However, long-term morphological and functional results of pars plana vitrectomy (PPV) with ERM and internal limiting membrane (ILM) peeling in eyes with central bouquet (CB) alterations have not yet been investigated. Methods: In a retrospective, consecutive study all patients underwent best corrected visual acuity (BCVA) testing and spectral domain optical coherence tomography (SD-OCT) before and after a mean of 20 months (range 3–70 months) postoperatively. CB abnormalities and ERMs were classified according to Govetto’s staging systems. Results: Of the 67 eyes, 22 (34%) showed CB abnormalities at baseline. The mean BCVA increased from 0.42 at baseline to 0.20 LogMAR at final follow-up (p < 0.001). Neither ERM stage (p = 0.06) nor CB stage (p = 0.939) at baseline were significant predictors of vision improvement following surgery. Conclusions: Our results show that baseline BCVA, but not classification of CB changes and ERM at baseline, seems to be a useful predictor for functional outcomes following PPV with ERM and ILM peeling in the long-term.

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Segmentation errors and motion artifacts in OCT-A associated with epiretinal membranes

Cited by 13 publications

References 32 publications

Effect of Foveal Pit Restoration in Foveal Avascular Zone after Surgery for Idiopathic Epiretinal Membrane

Effect of Foveal Pit Restoration in Foveal Avascular Zone after Surgery for Idiopathic Epiretinal Membrane

The Role of OCT Angiography in the Assessment of Epiretinal Macular Membrane

Influences of Central Bouquet Alterations on the Visual Outcome in Eyes Receiving Epiretinal Membrane Surgery

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