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Gregory Anderson, Alexandre R Tumlinson; Impact of image display on clinical utility of OCT Angiography. Invest. Ophthalmol. Vis. Sci. 2018;59(9):2863. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
Static images of OCT angiography en face slabs are limited in the ability to display pathologies that traverse between slabs. We hypothesize that greater clinical utility can be achieved through simultaneous presentation of multiple slabs. Retina specialists on the Advanced Retina Imaging (ARI) Network Hub (ZEISS, Dublin, CA) viewed OCT angiography slabs in multiple configurations to determine their relative clinical utility for Diabetic Retinopathy (DR) and Wet Age-Related Macular Degeneration (AMD).
Data were collected from 11 retina specialists for two clinical scenarios – wet AMD, and DR. Baseline was a single-image view any of eight preset slabs: VRI, superficial, retina, deep, avascular, ORCC, choriocapillaris, choroid, and three depth-encoded images – Retina (superficial, deep, avascular), Posterior (retina, choriocapillaris, choroid) and Outer (ORCC, choriocapillaris, choroid). Participants rated the clinical utility of each slab. In the second condition, participants compared multiple comparison view conditions to the baseline. The third condition measured relative clinical utility of user-adjustable depth-encoding.
For DR, participants rated the superficial, retina, deep and VRI slabs (M=4.46, SD=0.85) significantly more useful (p<0.05) than the other slabs (M=2.20, SD=1.24). For wet AMD, participants rated the Choriocapillaris, ORCC, Outer Depth Encoded, Posterior Depth Encoded and Choroid slabs (M=4.35, SD=0.80) significantly more useful (p<0.05) than the other slabs (M=2.19, SD=1.16).Comparison views (2, 3, & 4 images) were rated as more useful than the baseline by 91-100% of participants for DR and 64-82% for wet AMD. There was no significant difference in ratings among the three comparison views. User-adjustable encoding was rated as more useful than static depth-encoded images by 75% of participants (CI: 35%-97%, p<0.05) for DR and 73% of participants (CI: 39%-93%, p<0.05) for wet AMD.
For both clinical scenarios, comparison and user-adjusted depth encoding views of OCT angiography images were rated as providing additional clinical utility over single views and static depth-encoded slabs. Posterior and Outer depth-encoded images were rated among the most clinically useful images for wet AMD. Data suggest that display interface can contribute meaningfully to the clinical utility of OCT angiography data.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
User-adjustable Outer Depth Encoded (L) and Posterior Depth Encoded (R) stacks
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