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Repeatability and reproducibility of vessel density measurements on optical coherence tomography angiography in diabetic retinopathy

  • Retinal Disorders
  • Published:
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Abstract

Purpose

Understanding the precision of measurements on and across optical coherence tomography angiography (OCTA) devices is critical for tracking meaningful change in disease. The purpose of this study is to investigate the repeatability and reproducibility of vessel area density and vessel skeleton density measurements from various commercial OCTA devices in diabetic eyes.

Methods

Patients were imaged three consecutive times each on three different OCTA devices. En face OCTA images of the superficial capillary plexus, deep capillary plexus, and full retinal layer were exported for analysis. Vessel area density and vessel skeleton density were calculated. The coefficient of repeatability (CoR) was calculated to assess the repeatability of these measurements, and linear mixed models were utilized to assess the reproducibility of these measurements.

Results

Forty-four eyes from 27 diabetic patients were imaged. Normalized CoR values ranged between 3.44 and 6.65% when calculated for vessel area density and between 1.35 and 23.39% when calculated for vessel skeleton density. When stratified by disease severity, the swept-source OCTA device consistently produced the smallest CoR values for vessel area density in the full retinal layer. Vessel area density measurements were repeatable across the two spectral-domain devices in the full retinal layer when all severities were combined, as well as in diabetic patients without retinopathy, mild nonproliferative diabetic retinopathy (NPDR), and moderate NPDR.

Conclusion

Vessel area density measured in the full retinal layer may be a more precise measure than vessel skeleton density to follow diabetic retinopathy patients both on the same device and across devices.

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Funding

This study was funded by a Research to Prevent Blindness (RPB) Challenge grant made to the Department of Ophthalmology, Tufts Medical Center and by the Massachusetts Lions Club. The funding organizations have no role in the design or conduct of this research.

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Authors and Affiliations

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

    Emily S. Levine, Malvika Arya, Juhi Chaudhari, Eugenia Custo Greig, A. Yasin Alibhai, Caroline R. Baumal, Andre J. Witkin, Jay S. Duker & Nadia K. Waheed

  2. Tufts University School of Medicine, Boston, MA, USA

    Emily S. Levine

  3. Yale School of Medicine, New Haven, CT, USA

    Eugenia Custo Greig

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

    Nadia K. Waheed

Authors
  1. Emily S. Levine
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  2. Malvika Arya
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  3. Juhi Chaudhari
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  4. Eugenia Custo Greig
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  5. A. Yasin Alibhai
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  6. Caroline R. Baumal
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  7. Andre J. Witkin
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  8. Jay S. Duker
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  9. Nadia K. Waheed
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Corresponding author

Correspondence to Nadia K. Waheed.

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Conflict of interest

ESL, MA, JC, ECG, AYA, and AJW have no financial disclosures. CRB has received honoraria from Carl Zeiss Meditec, Optovue, Genentech, and Allergan. JSD has received funding from Carl Zeiss Meditec and Optovue; he has consulted for Aldeyra, Allergan, Aura Biosciences, Bausch Health, Beyeonics, Hemera Bio, Merck, Novartis, and Roche. NKW has received a speaker fee from Nidek Medical Products and Topcon; she has consulted for Topcon, Regeneron, Roche/Genentech, Apellis, Astellas, Boehringer Ingelheim, and Novartis; she has served on the advisory board for Topcon, Carl Zeiss Meditec, Roche/Genentech, Apellis, Astellas, Boehringer Ingelheim, and Novartis; she has stock in the Boston Image Reading Center and OcuDyne; she is an officer of entity and has personal financial interest in Gyroscope.

Ethical approval

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.

Informed consent

Informed consent was obtained from all participants included in this study.

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Emily S. Levine and Malvika Arya are the co-first authors

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Levine, E.S., Arya, M., Chaudhari, J. et al. Repeatability and reproducibility of vessel density measurements on optical coherence tomography angiography in diabetic retinopathy. Graefes Arch Clin Exp Ophthalmol 258, 1687–1695 (2020). https://doi.org/10.1007/s00417-020-04716-6

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  • DOI: https://doi.org/10.1007/s00417-020-04716-6

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