June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
Severity of OCTA Artifacts According to Disease Stage in Glaucoma Patients
Author Affiliations & Notes
  • Elizabeth Huai-Feng Li
    Shiley Eye Institute, Hamilton Glaucoma Center, University of California San Diego, La Jolla, California, United States
  • Alireza Kamalipour
    Shiley Eye Institute, Hamilton Glaucoma Center, University of California San Diego, La Jolla, California, United States
  • Sasan Moghimi
    Shiley Eye Institute, Hamilton Glaucoma Center, University of California San Diego, La Jolla, California, United States
  • Takashi Nishida
    Shiley Eye Institute, Hamilton Glaucoma Center, University of California San Diego, La Jolla, California, United States
  • Nevin W. El-Nimri
    Shiley Eye Institute, Hamilton Glaucoma Center, University of California San Diego, La Jolla, California, United States
  • Eleonora Micheletti
    Shiley Eye Institute, Hamilton Glaucoma Center, University of California San Diego, La Jolla, California, United States
  • Jo-Hsuan Wu
    Shiley Eye Institute, Hamilton Glaucoma Center, University of California San Diego, La Jolla, California, United States
  • Linda M Zangwill
    Shiley Eye Institute, Hamilton Glaucoma Center, University of California San Diego, La Jolla, California, United States
  • Robert N Weinreb
    Shiley Eye Institute, Hamilton Glaucoma Center, University of California San Diego, La Jolla, California, United States
  • Footnotes
    Commercial Relationships   Elizabeth Li None; Alireza Kamalipour None; Sasan Moghimi None; Takashi Nishida None; Nevin El-Nimri Topcon Healthcare, Code E (Employment); Eleonora Micheletti None; Jo-Hsuan Wu None; Linda Zangwill Abbvie, Digital Diagnostics, Code C (Consultant/Contractor), National Eye Institute, Carl Zeiss Meditec Inc., Heidelberg Engineering GmbH, Optovue Inc., Topcon Medical Systems Inc., Code F (Financial Support), Zeiss Meditec, Code P (Patent); Robert Weinreb Aerie Pharmaceuticals, Allergan, Eyenovia, Code C (Consultant/Contractor), Heidelberg Engineering, Carl Zeiss Meditec, Konan Medical, Optovue, Centervue, Bausch&Lomb, Code F (Financial Support), Toromedes, Meditec-Zeiss, Code P (Patent)
  • Footnotes
    Support  National Eye Institute R01EY029058, R01EY11008, R01EY19869, R01EY027510, R01EY026574, EY018926 P30EY022589, Unrestricted grants from Research to Prevent Blindness (New York, NY), EyeSight Foundation of Alabama; National Eye Institute; Research to Prevent Blindness, Tobacco-Related Disease Research Program T31IP1511
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 2946 – F0099. doi:
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    • Get Citation

      Elizabeth Huai-Feng Li, Alireza Kamalipour, Sasan Moghimi, Takashi Nishida, Nevin W. El-Nimri, Eleonora Micheletti, Jo-Hsuan Wu, Linda M Zangwill, Robert N Weinreb; Severity of OCTA Artifacts According to Disease Stage in Glaucoma Patients. Invest. Ophthalmol. Vis. Sci. 2022;63(7):2946 – F0099.

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

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Abstract

Purpose : To characterize the severity of optical coherence tomography angiography (OCTA) artifacts by disease severity in glaucoma suspects and patients.

Methods : 644 OCTA images were included from 409 eyes of 228 healthy, glaucoma suspect and glaucoma patients from the Diagnostic Innovations in Glaucoma Study. Angiovue high-density optic nerve head and macula OCTA images were reviewed for the presence of different subtypes of OCTA artifacts, including eye movement, defocus, decentration, segmentation error, blink, Z offset, and shadow in the superficial vascular layer. The severity of artifacts was quantified based on the percentage of the en-face image or B-scans affected. Artifacts that involved <5% of the OCTA scan were categorized as mild, 5-10% as moderate, and ≥10% as severe. Images with at least 1 severe artifact were classified as poor-quality. Univariable and multivariable mixed effect models were used to evaluate the association of demographic and ocular characteristics with artifact severity.

Results : 31.8% of OCTA images were classified as poor-quality. The prevalence of poor-quality images increased with worsening disease from healthy (13.6%) to glaucoma suspect (23.5%) to glaucoma patients (39.0%). In univariable analyses, diagnosis of glaucoma and worse 24-2 visual field (VF) mean deviation (MD) were significantly associated with poor-quality OCTA images (all P<0.05, Table 1). In the multivariable analysis, older age, male gender, absence of eye tracking and worse 24-2 VF MD were significantly associated with poor-quality OCTA images (all P<0.05). Defocus (21.1%), eye movement (19.6%) and decentration (6.7%) artifacts were the most prevalent subtypes of severe artifacts leading to poor-quality OCTA images. Each was significantly associated with severity of disease including worse 24-2 VF MD (all P<0.05). Compared to healthy subjects, both glaucoma suspect and glaucoma patients were more likely to have moderate to severe eye movement, but only glaucoma patients were more likely to have moderate to severe decentration and defocus artifacts (all P<0.05).

Conclusions : OCTA images of glaucoma patients, particularly those with severe disease, are more likely to be affected by artifacts compared to those of healthy individuals. Quantitative OCTA measurements of glaucoma patients, especially those with advanced disease, must be carefully reviewed to exclude images with artifacts.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

 

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