September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Foveal microvascular imaging: Optical coherence tomography angiography (OCTA) vs. adaptive optics scanning light ophthalmoscope fluorescein angiography (AOSLO FA)
Author Affiliations & Notes
  • Shelley Mo
    Icahn School of Medicine at Mount Sinai, New York, New York, United States
    Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York, United States
  • Brian Krawitz
    Icahn School of Medicine at Mount Sinai, New York, New York, United States
    Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York, United States
  • Eleni Efstathiadis
    Baruch College, New York, New York, United States
    Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York, United States
  • Lawrence Geyman
    Icahn School of Medicine at Mount Sinai, New York, New York, United States
    Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York, United States
  • Toco Yuen Ping Chui
    Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York, United States
    Icahn School of Medicine at Mount Sinai, New York, New York, United States
  • Joseph Carroll
    Ophthalmology, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
  • Alfredo Dubra
    Ophthalmology, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
    Biophysics, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
  • Richard B Rosen
    Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York, United States
    Icahn School of Medicine at Mount Sinai, New York, New York, United States
  • Footnotes
    Commercial Relationships   Shelley Mo, None; Brian Krawitz, None; Eleni Efstathiadis, None; Lawrence Geyman, None; Toco Chui, None; Joseph Carroll, Optovue (F); Alfredo Dubra, US Patent No: 8,226,236 (P); Richard Rosen, Advanced Cellular Technologies (C), Allergan (C), Carl Zeiss Meditech (C), Clarity (C), Genentech (F), NanoRetina (C), OD-OS (C), Opticology (I), Optovue (C), Regeneron (C)
  • Footnotes
    Support  Marrus Family Foundation, Bendheim-Lowenstein Family Foundation, Wise Family Foundation, New York Eye and Ear Chairman’s Research Fund, Violett Fund, Milbank Foundation, Research to Prevent Blindness
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 67. doi:
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    • Get Citation

      Shelley Mo, Brian Krawitz, Eleni Efstathiadis, Lawrence Geyman, Toco Yuen Ping Chui, Joseph Carroll, Alfredo Dubra, Richard B Rosen; Foveal microvascular imaging: Optical coherence tomography angiography (OCTA) vs. adaptive optics scanning light ophthalmoscope fluorescein angiography (AOSLO FA). Invest. Ophthalmol. Vis. Sci. 2016;57(12):67.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : OCTA is a promising clinical tool for noninvasive visualization of retinal microvasculature but it has not yet been validated with high resolution in vivo imaging. We used AOSLO FA in a side-by-side comparison with OCTA on healthy and diseased eyes to evaluate their similarities and differences.

Methods : 3 controls (3 eyes) and 6 patients (6 eyes) with diabetic retinopathy, branch retinal vein occlusion, or sickle cell retinopathy were imaged using a commercial OCTA system (Optovue Avanti RTVue-XR) and AOSLO FA (Pinhas et al., 2013). A 10x10° OCTA full vessel layer scan and a 6x6° AOSLO FA montage centered at the fovea were obtained for each eye (Fig. A&B) and skeletonized semi-automatically using custom software (Fig. C&D). Foveal avascular zone (FAZ) area, perimeter, and acircularity (FAZ perimeter divided by perimeter of circle with equal area) were measured. Vessel density at 3 annular regions of interest (ROI) defined by distance away from the FAZ margin (100, 200, & 300 µm) was computed as the total vessel length divided by ROI area. Paired t-tests were used to assess statistical significance. Images were compared for differences in vessel identification (Fig. C&D).

Results : OCTA and AOSLO FA demonstrated no statistically significant difference in FAZ perimeter, acircularity, and vessel density at all 3 ROIs. FAZ area showed a small but statistically significant difference (OCTA 0.38±0.27 vs. AOSLO FA 0.38±0.28 mm2; p=0.02). Certain vessel segments were seen on AOSLO FA but not on OCTA and vice versa (Fig. C-F). OCTA is prone to artifacts due to eye movement and lower lateral resolution compared to AOSLO FA but has short scan time and the ability to reveal multiple capillary layers in a single scan.

Conclusions : OCTA showed good comparability to AOSLO FA at the fovea in both healthy and diseased eyes with minor quantitative and qualitative differences. These results suggest that OCTA may serve as a good screening tool, but further evaluation in a larger group of eyes is needed.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

 

OCTA (top) and AOSLO FA images (bottom) of a control. A&B) Foveal perfusion maps. C&D) Skeletonized maps showing differences in vessel identification. E&F) Magnified regions (A&B yellow boxes); arrows indicate vessels visible only on OCTA. Scale bars: A-D 300µm; E&F 50µm.

OCTA (top) and AOSLO FA images (bottom) of a control. A&B) Foveal perfusion maps. C&D) Skeletonized maps showing differences in vessel identification. E&F) Magnified regions (A&B yellow boxes); arrows indicate vessels visible only on OCTA. Scale bars: A-D 300µm; E&F 50µm.

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