June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Comparative Evaluation of Review Strategies for Detection of Vascular Abnormalities on Optical Coherence Tomography Angiography in the AVATAR Study
Author Affiliations & Notes
  • Amy Shrader Babiuch
    Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
  • Mehnaz Khan
    Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
  • Ming Hu
    Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
  • Peter K Kaiser
    Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
  • Sunil K Srivastava
    Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
  • Rishi P Singh
    Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
  • Allison Watts
    Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
  • Jamie Reese
    Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
  • Justis Ehlers
    Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
  • Footnotes
    Commercial Relationships   Amy Babiuch, Allergan (R); Mehnaz Khan, None; Ming Hu, None; Peter Kaiser, Allergan (C), Bayer (C), Novartis (C), Regeneron (C); Sunil Srivastava, Alcon (C), Allergan (F), Bausch and Lomb (C), Bausch and Lomb (P), Bioptigen (P), Leica (P), Santen (C), Synergetics (P), Zeiss (C); Rishi Singh, Alcon (F), Apellis (F), Genentech (F), Genentech (C), Optos (C), Regeneron (F), Regeneron (C), Shire (C), Zeiss (C); Allison Watts, None; Jamie Reese, None; Justis Ehlers, Alcon (C), Alcon (F), Alimera (C), Allergan (C), Bausch and Lomb (P), Bioptigen (C), Bioptigen (P), Genentech (C), Genentech (F), Leica (C), Leica (P), Regeneron (F), Santen (C), Synergetics (P), Thrombogenics (C), Thrombogenics (F), Zeiss (C)
  • Footnotes
    Support  NIH/NEI K23-EY022947; Ohio Department of Development TECH-13-059; NIH-NEI P30 Core Grant (1P30EY025585-01A1)
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 1888. doi:
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      Amy Shrader Babiuch, Mehnaz Khan, Ming Hu, Peter K Kaiser, Sunil K Srivastava, Rishi P Singh, Allison Watts, Jamie Reese, Justis Ehlers; Comparative Evaluation of Review Strategies for Detection of Vascular Abnormalities on Optical Coherence Tomography Angiography in the AVATAR Study. Invest. Ophthalmol. Vis. Sci. 2017;58(8):1888.

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

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Abstract

Purpose : The purpose of this study is to compare review strategies for optical coherence tomography angiography (OCTA) for multiple pathologic features found in common diseases of the choroid and retina.

Methods : AVATAR is an IRB-approved prospective observational study of OCTA in eyes undergoing routine spectral-domain optical coherence tomography (SD-OCT) for macular disease. Patients were imaged with the Avanti RTVue XR HD (Optovue, Fremont, CA) and the SSADA algorithm software was utilized for OCTA performance. All scans of sufficient quality were reviewed by 2 masked independent expert reviewers. A third masked reviewer was utilized for any reviewer disagreement. A single report using automated segmentation within the Avanti software to represent the superficial retina, inner retina, and choroid was generated. A line-by-line video export was also reviewed for each OCTA scan. Each report was reviewed for the presence of three pathologic features: choroidal neovascularization, microaneurysms, and macular ischemia.

Results : Four hundred twenty-one eyes were included in the study. Of those, 350 scans were deemed sufficient for interpretation and analysis. Detection rates of choroidal neovascularization, microaneurysms, and macular ischemia on the report were 90.5%, 84.5%, and 95.4% respectively. Likewise, detection rates on the line-by-line review video were 88.1%, 96.4%, and 95.4% for choroidal neovascularization, microaneurysms, and macular ischemia respectively. Cohen’s kappa values ranged from 0.79 to 0.96, corresponding to good and very good agreement between the report and line-by-line review for each variable.

Conclusions : Defining an optimal reporting strategy for OCTA is important for diagnostic accuracy and optimizing workflow in retina clinics. In this study, an OCTA report using automated segmentation was comparable to line-by-line review for detecting microvascular abnormalities of the retina and choroid.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

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