June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
A Normative Database of Widefield Swept-Source Optical Coherence Tomography Angiography (WF SS-OCTA) Quantitative Vascular Metrics
Author Affiliations & Notes
  • Mary Kathleen Munsell
    Harvard Retinal Imaging Lab, Harvard Medical School, Boston, Massachusetts, United States
    Retina Service, Massachusetts Eye and Ear, Boston, Massachusetts, United States
  • Itika Garg
    Harvard Retinal Imaging Lab, Harvard Medical School, Boston, Massachusetts, United States
    Retina Service, Massachusetts Eye and Ear, Boston, Massachusetts, United States
  • Margaret Duich
    Harvard Retinal Imaging Lab, Harvard Medical School, Boston, Massachusetts, United States
  • Raviv Katz
    Harvard Retinal Imaging Lab, Harvard Medical School, Boston, Massachusetts, United States
    Retina Service, Massachusetts Eye and Ear, Boston, Massachusetts, United States
  • Rebecca Zeng
    Harvard Retinal Imaging Lab, Harvard Medical School, Boston, Massachusetts, United States
    Retina Service, Massachusetts Eye and Ear, Boston, Massachusetts, United States
  • Jade Yunkyung Moon
    Harvard Retinal Imaging Lab, Harvard Medical School, Boston, Massachusetts, United States
    Retina Service, Massachusetts Eye and Ear, Boston, Massachusetts, United States
  • Edward S Lu
    Harvard Retinal Imaging Lab, Harvard Medical School, Boston, Massachusetts, United States
    Retina Service, Massachusetts Eye and Ear, Boston, Massachusetts, United States
  • Diane N Sayah
    Harvard Retinal Imaging Lab, Harvard Medical School, Boston, Massachusetts, United States
    Retina Service, Massachusetts Eye and Ear, Boston, Massachusetts, United States
  • Hannah Wescott
    Harvard Retinal Imaging Lab, Harvard Medical School, Boston, Massachusetts, United States
    Retina Service, Massachusetts Eye and Ear, Boston, Massachusetts, United States
  • Nimesh A. Patel
    Retina Service, Massachusetts Eye and Ear, Boston, Massachusetts, United States
  • John B Miller
    Harvard Retinal Imaging Lab, Harvard Medical School, Boston, Massachusetts, United States
    Retina Service, Massachusetts Eye and Ear, Boston, Massachusetts, United States
  • Footnotes
    Commercial Relationships   Mary Munsell None; Itika Garg None; Margaret Duich None; Raviv Katz None; Rebecca Zeng None; Jade Moon None; Edward Lu None; Diane Sayah None; Hannah Wescott None; Nimesh Patel Alimera Sciences, Alcon, Allergan, Genentech, Code C (Consultant/Contractor); John Miller Alcon, Allergan, Carl Zeiss, Sunovion, Genentech, Code C (Consultant/Contractor)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 2914 – F0067. doi:
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    • Get Citation

      Mary Kathleen Munsell, Itika Garg, Margaret Duich, Raviv Katz, Rebecca Zeng, Jade Yunkyung Moon, Edward S Lu, Diane N Sayah, Hannah Wescott, Nimesh A. Patel, John B Miller; A Normative Database of Widefield Swept-Source Optical Coherence Tomography Angiography (WF SS-OCTA) Quantitative Vascular Metrics. Invest. Ophthalmol. Vis. Sci. 2022;63(7):2914 – F0067.

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

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Abstract

Purpose : Clinical and research interpretation of WF SS-OCTA requires reference to control data using similar imaging and analysis tools. Literature on WF SS-OCTA with large sample sizes is sparse and often limited to only vessel density (VD). We aimed to analyze a large number of healthy eyes to create the first normative database using the ARI network (Zeiss Portal).

Methods : In this cross-sectional observational study, 383 eyes of 302 subjects were imaged using 3x3mm, 6x6mm, and 12x12mm scans centered on the fovea using 100kHz WF SS-OCTA (PLEX® Elite 9000) between December 2018 and September 2021. Robust exclusion criteria included presence of hypertension, diabetes, glaucoma, >2+ cataract, refractive error >±6D, trauma, and ocular pathology. VD and vessel skeletonized density (VSD) were calculated in the superficial (SCP), deep capillary plexuses (DCP), and whole retina, as well as foveal avascular zone (FAZ) perimeter, area, and circularity (Macular Density Algorithm v0.7.3). Mixed effects linear regression was used.

Results : Subjects had a median age of 54 (11-83) years. 48.3% were male, 72.2% were white, and 8.3% reported Hispanic ethnicity. Median values of OCTA metrics for each scan size are reported (Table). Both VSD and VD decreased significantly with age in most layers and scan types (p<0.05). FAZ circularity also declined with age on 3x3mm (β=-0.001,p=0.001) and 6x6mm (β=-0.001,p=0.014) scans. No difference between males and females nor any effect modification with age was observed. No significant differences between white, Black, and Asian patients were observed. Hispanic patients had significantly higher whole retina VSD on 6x6mm (β=0.853, p=0.046) and higher VSD and VD on all 12x12mm layers (p<0.05) than non-Hispanic patients. Worse visual acuity was associated with significantly lower VSD and VD (p<0.05) and more irregular FAZ in all layers for all scans.

Conclusions : We present the first normative database of OCTA metrics obtained using standardized ARI network algorithms. This represents an uncommonly large sample of control eyes and includes broad vascular metrics as well as scans ranging from 3x3 to 12x12mm. Our results provide a valuable reference for past and future studies using this device.

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

 

 

Representative images. I: 3x3mm; II: 6x6mm; III: 12x12mm. A: Enface angiogram; B: Perfusion trace (VD). C: Skeletonized trace (VSD). D: FAZ (red).

Representative images. I: 3x3mm; II: 6x6mm; III: 12x12mm. A: Enface angiogram; B: Perfusion trace (VD). C: Skeletonized trace (VSD). D: FAZ (red).

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