Optical Coherence Tomography Angiography in Macular Neovascularization: A Comparison Between Different OCTA Devices

Area of Science:

• Ophthalmology
• Medical Imaging
• Neovascularization Research

Background:

• Macular neovascularization (MNV) diagnosis relies on imaging modalities.
• Optical coherence tomography angiography (OCTA) is a key technology for visualizing and quantifying MNV.
• Comparing different OCTA devices is crucial for consistent clinical application.

Purpose of the Study:

• To evaluate and compare the lesion area measurement capabilities of three distinct OCTA devices in patients with MNV.
• To assess the performance of OCTA in detecting different types of neovascularization (NV), including type 1, type 2, and mixed.

Main Methods:

• Utilized OCTA, fluorescein angiography (FA), indocyanine green angiography (ICGA), and structural optical coherence tomography (OCT).
• Performed NV lesion area measurements by two independent graders across different OCTA devices and imaging slabs.
• Included 28 eyes with various types of MNV (20 type 1, 6 type 2, 2 mixed).

Main Results:

• AngioVue and Spectralis OCTA devices demonstrated high detection rates (92.8%) for NV.
• High intraclass correlation coefficients (ICC) indicated excellent reader agreement for NV area measurements across devices and slabs.
• While mean NV areas did not differ significantly among instruments, median values varied significantly across different imaging slabs (avascular, ORCC, CC) for all devices.

Conclusions:

• Outer retina to choriocapillaris (ORCC) slabs exhibited the highest NV detection rates regardless of the OCTA device used.
• Swept source (SS)-OCTA measurements utilizing ORCC slabs showed superior NV detection compared to spectral domain (SD)-OCTA.
• OCTA's reliability in diagnosing NV is significant, with specific slab selections enhancing detection accuracy.