Reliability of Optical Coherence Tomography Angiography Retinal Blood Flow Analyses

Ella F Courtie; Ahmed Gilani; Nicholas Capewell; Aditya U Kale; Benjamin T K Hui; Xiaoxuan Liu; Giovanni Montesano; Michel Teussink; Alastair K Denniston; Tonny Veenith; Richard J Blanch

doi:10.1167/tvst.12.7.3

Reliability of Optical Coherence Tomography Angiography Retinal Blood Flow Analyses

Ella F Courtie, Ahmed Gilani, Nicholas Capewell, Aditya U Kale, Benjamin T K Hui, Xiaoxuan Liu, Giovanni Montesano, Michel Teussink, Alastair K Denniston, Tonny Veenith, Richard J Blanch^*

^*Corresponding author for this work

Inflammation and Ageing

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Abstract

PURPOSE: Investigate the association between the optical coherence tomography angiography (OCTA) metrics derived from different analysis programs to understand the comparability of studies using these different approaches.

METHODS: Secondary analysis of a prospective observational study (March 2018-September 2021). Forty-four right eyes and 42 left eyes from 44 patients were included. Patients were either undergoing upper gastrointestinal surgery with a critical care stay planned or were already in the critical care unit with sepsis. OCTA scans were obtained in an ophthalmology department or critical care setting. Fourteen OCTA metrics were compared within and between the programs, and agreement was measured by Pearson's R coefficient and intraclass correlation coefficient.

RESULTS: Correlation was highest between all Heidelberg metrics and Fractalyse (all >0.84), and lowest between Matlab skeletonized or foveal avascular zone metrics and all other measures (e.g., skeletal fractal dimension and vessel density at -0.02). Agreement between eyes was moderate to excellent in all metrics (0.60-0.90).

CONCLUSIONS: The significant variability between metrics and programs used for OCTA analysis demonstrates that they are not interchangeable and supports a recommendation for perfusion density metrics to be reported as standard.

TRANSLATIONAL RELEVANCE: Agreement between different OCTA analyses is variable and not interchangeable. The high agreement between non-skeletonized vessel density metrics suggests that these should be routinely reported.

Original language	English
Article number	3
Journal	Translational Vision Science & Technology
Volume	12
Issue number	7
DOIs	https://doi.org/10.1167/tvst.12.7.3
Publication status	Published - 3 Jul 2023

Bibliographical note

Acknowledgments
Supported by the National Institute for Health Research (NIHR) Surgical Reconstruction and Microbiology Research Centre (SRMRC). TV's research programme was supported by Medical Research Council. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.
Heidelberg Engineering provided the Heidelberg SPECTRALIS flex module for this study, but were not involved in data collection, analysis, or manuscript preparation.

Keywords

Humans
Fluorescein Angiography/methods
Retinal Vessels/diagnostic imaging
Tomography, Optical Coherence/methods
Reproducibility of Results
Macula Lutea

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title = "Reliability of Optical Coherence Tomography Angiography Retinal Blood Flow Analyses",

abstract = "PURPOSE: Investigate the association between the optical coherence tomography angiography (OCTA) metrics derived from different analysis programs to understand the comparability of studies using these different approaches.METHODS: Secondary analysis of a prospective observational study (March 2018-September 2021). Forty-four right eyes and 42 left eyes from 44 patients were included. Patients were either undergoing upper gastrointestinal surgery with a critical care stay planned or were already in the critical care unit with sepsis. OCTA scans were obtained in an ophthalmology department or critical care setting. Fourteen OCTA metrics were compared within and between the programs, and agreement was measured by Pearson's R coefficient and intraclass correlation coefficient.RESULTS: Correlation was highest between all Heidelberg metrics and Fractalyse (all >0.84), and lowest between Matlab skeletonized or foveal avascular zone metrics and all other measures (e.g., skeletal fractal dimension and vessel density at -0.02). Agreement between eyes was moderate to excellent in all metrics (0.60-0.90).CONCLUSIONS: The significant variability between metrics and programs used for OCTA analysis demonstrates that they are not interchangeable and supports a recommendation for perfusion density metrics to be reported as standard.TRANSLATIONAL RELEVANCE: Agreement between different OCTA analyses is variable and not interchangeable. The high agreement between non-skeletonized vessel density metrics suggests that these should be routinely reported.",

keywords = "Humans, Fluorescein Angiography/methods, Retinal Vessels/diagnostic imaging, Tomography, Optical Coherence/methods, Reproducibility of Results, Macula Lutea",

author = "Courtie, {Ella F} and Ahmed Gilani and Nicholas Capewell and Kale, {Aditya U} and Hui, {Benjamin T K} and Xiaoxuan Liu and Giovanni Montesano and Michel Teussink and Denniston, {Alastair K} and Tonny Veenith and Blanch, {Richard J}",

note = "Acknowledgments Supported by the National Institute for Health Research (NIHR) Surgical Reconstruction and Microbiology Research Centre (SRMRC). TV's research programme was supported by Medical Research Council. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. Heidelberg Engineering provided the Heidelberg SPECTRALIS flex module for this study, but were not involved in data collection, analysis, or manuscript preparation. ",

year = "2023",

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doi = "10.1167/tvst.12.7.3",

language = "English",

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AU - Courtie, Ella F

AU - Gilani, Ahmed

AU - Capewell, Nicholas

AU - Kale, Aditya U

AU - Hui, Benjamin T K

AU - Liu, Xiaoxuan

AU - Montesano, Giovanni

AU - Teussink, Michel

AU - Denniston, Alastair K

AU - Veenith, Tonny

AU - Blanch, Richard J

N1 - Acknowledgments Supported by the National Institute for Health Research (NIHR) Surgical Reconstruction and Microbiology Research Centre (SRMRC). TV's research programme was supported by Medical Research Council. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. Heidelberg Engineering provided the Heidelberg SPECTRALIS flex module for this study, but were not involved in data collection, analysis, or manuscript preparation.

PY - 2023/7/3

Y1 - 2023/7/3

N2 - PURPOSE: Investigate the association between the optical coherence tomography angiography (OCTA) metrics derived from different analysis programs to understand the comparability of studies using these different approaches.METHODS: Secondary analysis of a prospective observational study (March 2018-September 2021). Forty-four right eyes and 42 left eyes from 44 patients were included. Patients were either undergoing upper gastrointestinal surgery with a critical care stay planned or were already in the critical care unit with sepsis. OCTA scans were obtained in an ophthalmology department or critical care setting. Fourteen OCTA metrics were compared within and between the programs, and agreement was measured by Pearson's R coefficient and intraclass correlation coefficient.RESULTS: Correlation was highest between all Heidelberg metrics and Fractalyse (all >0.84), and lowest between Matlab skeletonized or foveal avascular zone metrics and all other measures (e.g., skeletal fractal dimension and vessel density at -0.02). Agreement between eyes was moderate to excellent in all metrics (0.60-0.90).CONCLUSIONS: The significant variability between metrics and programs used for OCTA analysis demonstrates that they are not interchangeable and supports a recommendation for perfusion density metrics to be reported as standard.TRANSLATIONAL RELEVANCE: Agreement between different OCTA analyses is variable and not interchangeable. The high agreement between non-skeletonized vessel density metrics suggests that these should be routinely reported.

AB - PURPOSE: Investigate the association between the optical coherence tomography angiography (OCTA) metrics derived from different analysis programs to understand the comparability of studies using these different approaches.METHODS: Secondary analysis of a prospective observational study (March 2018-September 2021). Forty-four right eyes and 42 left eyes from 44 patients were included. Patients were either undergoing upper gastrointestinal surgery with a critical care stay planned or were already in the critical care unit with sepsis. OCTA scans were obtained in an ophthalmology department or critical care setting. Fourteen OCTA metrics were compared within and between the programs, and agreement was measured by Pearson's R coefficient and intraclass correlation coefficient.RESULTS: Correlation was highest between all Heidelberg metrics and Fractalyse (all >0.84), and lowest between Matlab skeletonized or foveal avascular zone metrics and all other measures (e.g., skeletal fractal dimension and vessel density at -0.02). Agreement between eyes was moderate to excellent in all metrics (0.60-0.90).CONCLUSIONS: The significant variability between metrics and programs used for OCTA analysis demonstrates that they are not interchangeable and supports a recommendation for perfusion density metrics to be reported as standard.TRANSLATIONAL RELEVANCE: Agreement between different OCTA analyses is variable and not interchangeable. The high agreement between non-skeletonized vessel density metrics suggests that these should be routinely reported.

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KW - Fluorescein Angiography/methods

KW - Retinal Vessels/diagnostic imaging

KW - Tomography, Optical Coherence/methods

KW - Reproducibility of Results

KW - Macula Lutea

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DO - 10.1167/tvst.12.7.3

M3 - Article

C2 - 37395705

SN - 2164-2591

VL - 12

JO - Translational Vision Science & Technology

JF - Translational Vision Science & Technology

IS - 7

M1 - 3

ER -

Reliability of Optical Coherence Tomography Angiography Retinal Blood Flow Analyses

Abstract

Bibliographical note

Keywords

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