Three Different Optical Coherence Tomography Angiography Measurement Methods for Assessing Capillary Density Changes in Diabetic Retinopathy

Pedinielli, Alexandre; Bonnin, Sophie; Sanharawi, Mohamed El; Mané, Valérie; Erginay, Ali; Couturier, Aude; Tadayoni, Ramin

doi:10.3928/23258160-20170428-03

Cited by 27 publications

(19 citation statements)

References 23 publications

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“…Using this approach the combined model achieved a sensitivity of 86% and a specificity of 70% in the NPDR versus PDR group, compared to the previously reported sensitivity/specificity of 90%/44% for the SCP vessel density alone and 91%/50% for the DCP vessel density alone. 33 Furthermore, the same model performed well in the NoDR versus any DR group with a sensitivity of 89% and specificity of 96%, which compares favorably with previous attempts to differentiate normal eyes and eyes with DR, with the important difference that it is considerably harder to detect changes between NoDR and eyes with any DR. 5 , 34 …”

Section: Discussionsupporting

confidence: 66%

Statistical Model of Optical Coherence Tomography Angiography Parameters That Correlate With Severity of Diabetic Retinopathy

Ashraf

Nesper

Jampol

et al. 2018

Invest. Ophthalmol. Vis. Sci.

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PurposeTo determine whether combining quantitative optical coherence tomography angiography (OCTA) parameters can achieve high sensitivity and specificity to distinguish eyes with nonproliferative diabetic retinopathy (NPDR) from those with proliferative diabetic retinopathy (PDR) as well as eyes with diabetes and no DR (NoDR) from those with clinical DR (any DR).MethodsThis cross-sectional study included 28 eyes (17 patients) with NoDR, 54 eyes (34 patients) with NPDR, and 56 eyes (36 patients) with PDR. OCTA images were processed to quantify the foveal avascular zone (FAZ) area, acircularity, vessel density, skeletonized vessel density, fractal dimension, and intersections and average vessel diameter for the superficial (SCP) and the deep capillary plexus (DCP). Binary logistic regression models were used to identify the OCTA parameters that best distinguished DR severity groups. The area (AUC) under the receiver operating characteristic (ROC) curves, and sensitivity and specificity were calculated for each model.ResultsThe regression model identified the SCP FAZ area, DCP vessel density, and acircularity as parameters that best distinguished between DR severity groups. ROC curves for NPDR versus PDR had an AUC of 0.845 (P < 0.001) and sensitivity and specificity of 86% and 70%, respectively. ROC curves for NoDR versus any DR showed an AUC of 0.946 (P < 0.001) with sensitivity of 89% and specificity of 96%, with comparable results when explored in males and females separately.ConclusionsWe identified a set of OCTA parameters with high sensitivity and specificity for distinguishing between groups based on DR severity, suggesting potential clinical application for OCTA as a screening tool for DR.

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Section: Discussionsupporting

confidence: 66%

Statistical Model of Optical Coherence Tomography Angiography Parameters That Correlate With Severity of Diabetic Retinopathy

Ashraf

Nesper

Jampol

et al. 2018

Invest. Ophthalmol. Vis. Sci.

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“…Various vascular quantifications have been described including the area filled by binarized vessels (vessel area density = VD) or skeletonized vessels (vessel perfusion density = PD), vessel spacing or intercapillary area, length of the blood vessel based on the skeletonized OCTA (vascular length density = VLD or skeleton density = SD), vessel diameter index (VDI, calculated as VD divided by VLD), total length of vessels (vessel length fraction), vascular architecture, and branching [tortuosity and fractal dimension (FD)], and nonperfusion indexes (NPI). [ 12 17 19 34 44 64 65 66 ] To our knowledge, only VD indices and PD maps are available in some commercially available OCTA devices. SD, VD, FD, and VDI showed high reproducibility among graders.…”

Section: Resultsmentioning

confidence: 99%

“…Although the automated method may distinguish diabetic changes as early as severe NPDR, other methods can detect significant VD changes only in the more advanced stages of retinopathy (PDR). [ 65 ] Repeated VD measurements using the same device is reliable; however, significant variability exists in measurements using different devices and methods. [ 59 ] Hence, comparisons should be made using the same type of device.…”

Section: Resultsmentioning

confidence: 99%

An update on optical coherence tomography angiography in diabetic retinopathy

Khadamy¹,

Aghdam²,

Falavarjani³

2018

J Ophthalmic Vis Res

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Optical coherence tomography angiography (OCTA) is a novel non-invasive imaging modality for 3-dimensional visualization of retinal and optic nerve capillary networks. In this article, a comprehensive review of relevant original articles in the PubMed database was performed using the search terms “diabetic retinopathy,” “diabetic macular edema,” “diabetes mellitus,” and “optical coherence tomography angiography.” OCTA was found to detect microvascular changes early in diabetes mellitus, even before they become clinically evident. Morphological and qualitative assessment of vascular changes can help to determine the pathophysiological processes, activity, treatment, and follow-up of diabetic retinopathy (DR). Vessel density and foveal avascular zone are the most investigated quantified indices shown to be early predictors of DR, correlated to DR severity and visual function, and useful in predicting response to treatment. OCTA has shown to be a promising alternative to fluorescein angiography in the management of DR. Further studies are warranted to determine the role of OCTA in the routine clinical management of DR.

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“…Only one study has provided some information about the impact of different post-processing imaging. Pedinielli et al [ 38 ] observed that the same image may lead to different macular vessel density values if quantified by means of skeletonization, mean thresholding, or proprietary AngioVue software (Optovue, Inc., Fremont, CA, USA). Differences between vessel density obtained by means of skeletonization and thresholding were predictable since they measure different units.…”

Section: Discussionmentioning

confidence: 99%

Comparison of methods to quantify macular and peripapillary vessel density in optical coherence tomography angiography

et al. 2018

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PurposeTo compare macular and peripapillary vessel density values calculated on optical coherence tomography angiography (OCT-A) images with different algorithms, elaborate conversion formula, and compare the ability to discriminate healthy from affected eyes.MethodsCross-sectional study of healthy subjects, patients with diabetic retinopathy, and glaucoma patients (44 eyes in each group). Vessel density in the macular superficial capillary plexus (SCP), deep capillary plexus (DCP), and the peripapillary radial capillary plexus (RCP) were calculated with seven previously published algorithms. Systemic differences, diagnostic properties, reliability, and agreement of the methods were investigated.ResultsHealthy eyes exhibited higher vessel density values in all plexuses compared to diseased eyes regardless of the algorithm used (p<0.01). The estimated vessel densities were significantly different at all the plexuses (p<0.0001) as a function of method used. Inter-method reliability and agreement was mostly poor to moderate. A conversion formula was available for every method, except for the conversion between multilevel and fixed at the DCP. Substantial systemic, non-constant biases were evident between many algorithms. No algorithm outperformed the others for discrimination of patients from healthy subjects in all the retinal plexuses, but the best performing algorithm varied with the selected plexus.ConclusionsAbsolute vessel density values calculated with different algorithms are not directly interchangeable. Differences between healthy and affected eyes could be appreciated with all methods with different discriminatory abilities as a function of the plexus analyzed. Longitudinal monitoring of vessel density should be performed with the same algorithm. Studies adopting vessel density as an outcome measure should not rely on external normative databases.

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Three Different Optical Coherence Tomography Angiography Measurement Methods for Assessing Capillary Density Changes in Diabetic Retinopathy

Abstract: Only one of the three methods allowed for the detection of changes from the normal capillary density as early as at the "severe nonproliferative DR" stage due to several refinements from the basic technique. [Ophthalmic Surg Lasers Imaging Retina. 2017;48:378-384.].

Cited by 27 publications

References 23 publications

Statistical Model of Optical Coherence Tomography Angiography Parameters That Correlate With Severity of Diabetic Retinopathy

Statistical Model of Optical Coherence Tomography Angiography Parameters That Correlate With Severity of Diabetic Retinopathy

An update on optical coherence tomography angiography in diabetic retinopathy

Comparison of methods to quantify macular and peripapillary vessel density in optical coherence tomography angiography

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