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Effects of enhanced depth imaging and en face averaging on optical coherence tomography angiography image quantification

  • Retinal Disorders
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To examine the effects of enhanced depth imaging (EDI) and en face averaging on global vascular measurements of optical coherence tomography angiography (OCTA) images.

Methods

All eyes were imaged with 3 mm × 3 mm fields centered at the fovea using the Carl Zeiss Cirrus 5000 spectral-domain OCTA, with and without EDI, and the Zeiss PLEX Elite 9000 swept-source OCTA. Vessel area density (VAD), vessel length (VL), and vessel diameter index (VDI) were calculated for the superficial capillary plexus (SCP) en face angiograms. For the choriocapillaris (CC), VAD and the number, total area, and average size of flow voids were calculated. These metrics were compared between SD- and SS-OCTA images, with and without en face averaging and EDI.

Results

Both averaging and EDI had a significant effect on quantitative metrics. EDI images trended toward a decrease in SCP VAD. In the CC, EDI decreased average flow void size. Averaging increased CC VAD while decreasing number of flow voids, total flow void area, and average flow void size. With both averaging and EDI, SD-OCTA was not able to visualize as many CC flow voids, particularly of a smaller size, compared with SS-OCTA.

Conclusions

Averaging and EDI affect quantitative metrics from SCP and CC OCTA images. EDI resulted in a trend toward decreased VAD in SCP images. Averaging had a major effect on CC imaging. Even with the combination of EDI and en face averaging, SD-OCTA images do not appear to approximate SS-OCTA images in terms of quantitative metrics. This has implications for clinical and research use of SD-OCTA for retinal imaging.

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Funding

This work was financially supported by the Macula Vision Research Foundation (West Conshohocken, PA, USA), the Massachusetts Lions Clubs (Belmont, MA, USA), the National Institutes of Health (Bethesda, MD, USA; grant number 5-R01-EY011289-31), the Air Force Office of Scientific Research (Arlington, VA, USA; grant number FA9550-15-1-0473), and the Champalimaud Vision Award (Lisbon, Portugal), the Beckman-Argyros Award in Vision Research (Irvine, CA, USA).

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Authors and Affiliations

  1. New England Eye Center, Tufts Medical Center, Boston, MA, USA

    Keke Liu, Nihaal Mehta, A. Yasin Alibhai, Malvika Arya, Osama Sorour, Akihiro Ishibazawa, Caroline R. Baumal, Andre J. Witkin, Jay S. Duker & Nadia K. Waheed

  2. University of Hawai’i John A. Burns School of Medicine, Honolulu, HI, USA

    Keke Liu

  3. The Warren Alpert Medical School of Brown University, Providence, RI, USA

    Nihaal Mehta

  4. Department of Ophthalmology, Tanta University, Tanta, Egypt

    Osama Sorour

  5. Department of Ophthalmology, Asahikawa Medical University, Asahikawa, Japan

    Akihiro Ishibazawa

  6. Doheny Image Reading Center, Doheny Eye Institute, Los Angeles, CA, USA

    Iksoo Byon & SriniVas R. Sadda

  7. Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA

    Iksoo Byon & SriniVas R. Sadda

  8. Department of Ophthalmology, Tufts Medical Center, 800 Washington Street, Box 450, Boston, MA, 02111, USA

    Caroline R. Baumal, Andre J. Witkin, Jay S. Duker & Nadia K. Waheed

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  1. Keke Liu
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  2. Nihaal Mehta
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  11. SriniVas R. Sadda
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  12. Nadia K. Waheed
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Corresponding author

Correspondence to Nadia K. Waheed.

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Conflict of interest

Dr. Ishibazawa reports personal fees from Topcon Corporation, outside the submitted work. Dr. Baumal reports personal fees from Carl Zeiss Meditec, and personal fees from Optovue, outside the submitted work. Dr. Duker reports grants from Carl Zeiss Meditech, grants from Optovue, is a consultant for Allegro, is a consultant for Allergan, is a consultant for Aura Biosciences, is a consultant for Beyeonics, is a consultant for Helio Vision, is a consultant for Novartis, is a consultant for Roche, is a consultant for Santen, is a consultant for Sigilon, is a consultant for Hemera Biosciences, is a consultant for Sesen BIO, and is a consultant for Eyepoint Pharma, outside the submitted work. Dr. Sadda reports personal fees from Genentech, personal fees from Allergan, personal fees from Novartis, personal fees from 4DMT, personal fees from Oxurion, grants and personal fees from Optos, personal fees from Heidelberg, grants from Carl Zeiss Meditec, personal fees from Centervue, personal fees from Topcon, and personal fees from Amgen, outside the submitted work. Dr. Waheed reports personal fees and non-financial support from Nidek Medical Products, non-financial support from Carl Zeiss Meditec, grants from Macula Vision Research Foundation, personal fees from Topcon Corporation, personal fees from Optovue, personal fees from Heidelberg Engineering, grants from Massachusetts Lions Club, and grants from Beckman-Argyros Award in Vision Research, outside the submitted work. No disclosures exist for the remaining authors.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the Tufts Medical Center Institutional Review Board and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Liu, K., Mehta, N., Alibhai, A.Y. et al. Effects of enhanced depth imaging and en face averaging on optical coherence tomography angiography image quantification. Graefes Arch Clin Exp Ophthalmol 258, 979–986 (2020). https://doi.org/10.1007/s00417-020-04610-1

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  • DOI: https://doi.org/10.1007/s00417-020-04610-1

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