July 2019
Volume 60, Issue 9
Free
ARVO Annual Meeting Abstract  |   July 2019
Comparison of Reproducibility of Foveal Avascular Zone Measurement using Optical Coherence Tomography Angiography and Fluorescein Angiography
Author Affiliations & Notes
  • Khalid Yusuf Yaseen Al-Kirwi
    Ophthalmology, Byers Eye Institute, Palo Alto, California, United States
    Ophthalmology, Imamein Khadhimein Medical City University Hospital, Baghdad, Iraq
  • Günay Uludağ
    Ophthalmology, Byers Eye Institute, Palo Alto, California, United States
  • Muhammad Hassan
    Ophthalmology, Byers Eye Institute, Palo Alto, California, United States
  • Maria Soledad Ormaechea
    Ophthalmology, Byers Eye Institute, Palo Alto, California, United States
    Ophthalmology, Hospital Universitario Austral, Pilar, Buenos Aires, Argentina
  • Qienyuan Zhou
    Optovue Inc, Fremont, California, United States
  • Muhammad Sohail Halim
    Ophthalmology, Byers Eye Institute, Palo Alto, California, United States
  • Anh Ngoc Tram Tran
    Ophthalmology, Byers Eye Institute, Palo Alto, California, United States
  • Rubbia Afridi
    Ophthalmology, Byers Eye Institute, Palo Alto, California, United States
  • Jeong Hun Bae
    Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea (the Republic of)
  • Diana V Do
    Ophthalmology, Byers Eye Institute, Palo Alto, California, United States
  • Mohamed A Ibrahim
    Ocular Imaging Research and Reading Center, Menlo Park, California, United States
  • Quan Dong Nguyen
    Ophthalmology, Byers Eye Institute, Palo Alto, California, United States
  • Yasir Jamal Sepah
    Ophthalmology, Byers Eye Institute, Palo Alto, California, United States
  • Footnotes
    Commercial Relationships   Khalid Al-Kirwi, None; Günay Uludağ, None; Muhammad Hassan, None; Maria Ormaechea, None; Qienyuan Zhou, None; Muhammad Sohail Halim, None; Anh Tran, None; Rubbia Afridi, None; Jeong Hun Bae, None; Diana Do, None; Mohamed Ibrahim, Ocular Imaaging Research and Reading Center (E); Quan Nguyen, None; Yasir Jamal Sepah, None
  • Footnotes
    Support  NEI P30-EY026877, and Research to Prevent Blindness, Inc
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 3006. doi:
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      Khalid Yusuf Yaseen Al-Kirwi, Günay Uludağ, Muhammad Hassan, Maria Soledad Ormaechea, Qienyuan Zhou, Muhammad Sohail Halim, Anh Ngoc Tram Tran, Rubbia Afridi, Jeong Hun Bae, Diana V Do, Mohamed A Ibrahim, Quan Dong Nguyen, Yasir Jamal Sepah; Comparison of Reproducibility of Foveal Avascular Zone Measurement using Optical Coherence Tomography Angiography and Fluorescein Angiography. Invest. Ophthalmol. Vis. Sci. 2019;60(9):3006.

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

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Abstract

Purpose : To compare the reproducibility of foveal avascular zone (FAZ) measurements using semi-automated optical coherence tomography angiography (OCTA) FAZ measurement tool with manual FAZ calculations performed on fluorescein angiography (FA)

Methods : Eyes of patients with different retinal diseases from 3 clinical sites were enrolled in the study. A 3x3 mm foveal OCTA scan captured using Optovue Angiovue and an early phase FA image of the same eye captured using regular fundus camera were utilized for FAZ measurements. The automated FAZ measurement tool of the ReVue software (Version: 2017.1.0.151) was utilized to measure the area of the FAZ on OCTA scans. Manual adjustments to the FAZ measurements were performed. Image J (Version: 1.52a) was utilized to calculate the area of FAZ on FA images. Three independent graders performed these measurements on OCTA and FA images. The inter-grader reproducibility of FAZ measurements was assessed for both OCTA and FA images using concordance correlation coefficients; Bland & Altman plots were created (Figure). Automated FAZ measurements that required manual correction of ≥50% of original FAZ value were identified.

Results : Thirty eyes (26 subjects; 12 females) were analyzed in the study. The case series consisted of: 4 eyes (normal); 3 [neovascular age-related macular degeneration (AMD)]; 7 (non-proliferative diabetic retinopathy); 5 (proliferative diabetic retinopathy); 4 (branch retinal vein occlusion); and 7 (other retinal pathologies: dry AMD, central serous retinopathy, macular telangiectasia, and epiretinal membrane). Correlation coefficients of the FAZ measurements using FA and OCTA among graders are shown (Table). Measurements of FAZ by OCTA showed consistently higher reproducibility among the graders compared to FA measurements. Manual correction of ≥ 50% occurred in less than or equal to ≤16.6% of the cases.

Conclusions : OCTA is a non-invasive technique which allows for higher reproducibility and inter-grader agreement compared to FA for FAZ measurements.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

 

Figure Bland & Altman graphs for correlation of foveal avascular zone measurements for FA and OCTA

Figure Bland & Altman graphs for correlation of foveal avascular zone measurements for FA and OCTA

 

Table Concordance correlation coefficients amongst graders for FA and
OCTA

Table Concordance correlation coefficients amongst graders for FA and
OCTA

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