Imaging Artifacts and Segmentation Errors With Wide-Field Swept-Source Optical Coherence Tomography Angiography in...

Area of Science:

• Ophthalmology
• Medical Imaging
• Retinal Imaging

Background:

• Diabetic retinopathy (DR) is a leading cause of vision loss.
• Accurate assessment of retinal microvasculature is crucial for DR management.
• Wide-field swept-source optical coherence tomography angiography (SS-OCTA) offers noninvasive visualization of retinal vasculature.

Purpose of the Study:

• To analyze imaging artifacts and segmentation errors in wide-field SS-OCTA for diabetic retinopathy (DR).
• To identify factors influencing image quality in SS-OCTA for DR assessment.

Main Methods:

• Prospective, observational study including patients with nonproliferative DR (NPDR), proliferative DR (PDR), no DR, and healthy controls.
• Wide-field SS-OCTA imaging using Montage Angio (15 × 9 mm).
• Independent grading of images for motion artifact score (MAS) and segmentation errors; statistical analysis using SPSS and R software.

Main Results:

• Higher MAS correlated with increased DR severity (P < 0.05).
• Segmentation error rates were 0% (healthy), 10.53% (no DR), 10.00% (NPDR), and 50% (PDR).
• DR severity and dry eye were significant factors affecting MAS (P < 0.05); some artifacts were correctable.

Conclusions:

• Wide-field SS-OCTA is valuable for assessing retinal microvascular changes in DR.
• Distinguishing artifacts from true vascular alterations is critical for accurate interpretation.
• DR severity and dry eye impact SS-OCTA image quality, necessitating artifact reduction strategies for clinical use and trials.