June 2020
Volume 61, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2020
Image Quality and Retinal Vascular Metrics in the Community using Optical Coherence Tomography Angiography
Author Affiliations & Notes
  • Saleema A. Kherani
    Johns Hopkins University, Baltimore, Maryland, United States
  • Xinxing Guo
    Johns Hopkins University, Baltimore, Maryland, United States
  • Lubaina Arsiwala
    Johns Hopkins University, Baltimore, Maryland, United States
  • Yanan Dong
    Johns Hopkins University, Baltimore, Maryland, United States
  • Xiangrong Kong
    Johns Hopkins University, Baltimore, Maryland, United States
  • A. Richey Sharrett
    Johns Hopkins University, Baltimore, Maryland, United States
  • Pradeep Y Ramulu
    Johns Hopkins University, Baltimore, Maryland, United States
  • David Huang
    Casey Eye Institute, OHSU, Portland, Oregon, United States
  • Brandon J Lujan
    Casey Eye Institute, OHSU, Portland, Oregon, United States
  • Alexander Tomlinson
    Casey Eye Institute, OHSU, Portland, Oregon, United States
  • Alison Abraham
    Johns Hopkins University, Baltimore, Maryland, United States
  • Footnotes
    Commercial Relationships   Saleema Kherani, None; Xinxing Guo, None; Lubaina Arsiwala, None; Yanan Dong, None; Xiangrong Kong, None; A. Richey Sharrett, None; Pradeep Ramulu, Aerie Pharmaceuticals (C), Perfuse Therapeutics (C), W. L. Gone (C); David Huang, Optovue, Inc (F), Optovue, Inc (I), Optovue, Inc (P), Optovue, Inc (R); Brandon Lujan, None; Alexander Tomlinson, None; Alison Abraham, None
  • Footnotes
    Support  R01AG052412
Investigative Ophthalmology & Visual Science June 2020, Vol.61, 1606. doi:
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      Saleema A. Kherani, Xinxing Guo, Lubaina Arsiwala, Yanan Dong, Xiangrong Kong, A. Richey Sharrett, Pradeep Y Ramulu, David Huang, Brandon J Lujan, Alexander Tomlinson, Alison Abraham; Image Quality and Retinal Vascular Metrics in the Community using Optical Coherence Tomography Angiography. Invest. Ophthalmol. Vis. Sci. 2020;61(7):1606.

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

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Abstract

Purpose : Retinal markers from optical coherence tomography angiography (OCTA) are of growing interest in epidemiological studies. We evaluated the impact of image quality on the estimation of OCTA retinal vascular metrics in a community-based sample of older adults.

Methods : Optovue RTVue 6x6mm2 OCTA macular images were captured in participants from the Eye Determinants of Cognition (EyeDOC) study. Images were graded as passed or failed quality assessment (QA) by trained graders at an established OCTA reading center. Passed images had signal strength index (SSI) ≥55 and absence of significant image artifacts. We included 120 QA pass-fail image pairs from the same eye. Vessel density (VD) of superficial capillary plexus (SCP, from internal limiting membrane to inner plexiform layer), and deep capillary plexus (DCP, from inner nuclear layer to outer plexiform layer) within 3 ETDRS rings – foveal (1mmx1mm), parafoveal (3mmx3mm), and perifoveal (6mmx6mm) – and foveal avascular zone (FAZ) area were estimated by Optovue software. Overall agreement between each QA pass-fail pair was assessed by intraclass correlations (ICC) and Bland-Altman plots. Agreement was also assessed as a function of image SSI.

Results : The median SSI was 57 (range 38-73) in the failed images. The median percentage differences between the passed and failed images were <4% for both SCP and DCP VD of the entire scanning area. For all the VD parameters, ICCs were higher for SCP compared to DCP. ICCs ranged between 0.81-0.92 for SCP, 0.61-0.85 for DCP, and 0.77-0.86 for FAZ parameters (Table 1). Bland-Altman plots showed good agreement among all retinal vascular parameters for SCP and DCP. Review of OCTA images with poor agreement indicated the following contributors: pathology causing significant distortion of retinal architecture; SSI <47 with scan quality <5; ≥1 artifact involving the center or multiple quadrants.

Conclusions : Average agreement of retinal vascular metrics for SCP and DCP between 6x6mm2 OCTA images across a range of quality was good, though there was substantial variability. For epidemiologic research, lower quality images may provide sufficient information about retinal vascular health. However, retinal vascular metrics are not recoverable in images with low SSI and scan quality, presence of significant retinal pathology, and fovea-involving artifacts.

This is a 2020 ARVO Annual Meeting abstract.

 

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