Precision (repeatability and reproducibility) of papillary and peripapillary vascular density measurements using
Ruru Chen1, Xinyu Liu1, Mingyu Yao1
1School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.
Insights
Optical coherence tomography angiography (OCTA) shows good repeatability and reproducibility for measuring papillary and peripapillary vascular density (VD) in children. Signal strength index and axial length influence these measurements.
Area of Science:
- Ophthalmology
- Medical Imaging
- Pediatric Eye Care
Background:
- Optical coherence tomography angiography (OCTA) is increasingly used in pediatric eye examinations.
- Limited data exists on the reliability of OCTA for assessing papillary and peripapillary vascular density (VD) in healthy children.
Purpose of the Study:
- To evaluate the repeatability and reproducibility of papillary and peripapillary VD measurements using OCTA in children.
- To investigate the impact of signal strength index (SSI) and axial length (AL) on the precision of these OCTA measurements.
Main Methods:
- Prospective observational study involving 78 healthy children (aged 6-16 years).
- Two sets of 4.5 × 4.5 mm OCTA disc scans were performed by each of two examiners.
- Statistical analyses included within-subject standard deviation (Sw), test-retest reproducibility (TRT), coefficient of variation (CoV), intraclass correlation coefficient (ICC), and Bland-Altman analysis.
Main Results:
- OCTA demonstrated moderate-to-good repeatability and reproducibility for papillary and peripapillary VD measurements.
- VD showed negative correlations with SSI in most peripapillary sectors.
- AL was positively correlated with inferior temporal VD and negatively with superior nasal VD.
Conclusions:
- OCTA is a reliable tool for assessing papillary and peripapillary perfusion in healthy children.
- SSI significantly influences peripapillary VD, while AL has a more localized effect on specific peripapillary regions.
Importance:
Optical coherence tomography angiography (OCTA) has been widely applied into children, however, few studies have assessed the repeatability and reproducibility of papillary and peripapillary VD in healthy children.
Objective:
To assess the precision of papillary and peripapillary vascular density (VD) measurements using optical coherence tomography angiography (OCTA) and analyze the effects of the signal strength index (SSI) and axial length (AL) on precision estimates.
Design Setting And Participants:
This was a prospective observational study. Seventy-eight children aged 6-16 years underwent 4.5 × 4.5 mm OCTA (RTVue XR Avanti) disc scans: two scans by one examiner (repeatability) and two additional scans by another examiner (reproducibility). Within-subject standard deviation (Sw), test-retest reproducibility (TRT), within-subject coefficient of variation (CoV), intraclass correlation coefficient (ICC), and Bland-Altman analysis were performed.
Main Outcomes And Measures:
In repeatability measurement, the fluctuation ranges (minimum to maximum) of VD between intraexaminer A/B in Sw, TRT, CoV, and ICC were (1.05-2.17)% / (1.16-2.32)%, (2.9-6)% / (3.21-6.44)%, (1.9-4.47)% / (2.08-5)%, and (0.588-0.783)% / (0.633-0.803)%, respectively. In reproducibility measurement, the fluctuation ranges of VD in Sw, TRT, CoV, and ICC were 1.11-2.13%, 3.07-5.91%, 1.99-4.41%, and 0.644-0.777%, respectively. VD was negatively correlated with SSI in most sectors of the peripapillary (e.g., inferior nasal, temporal inferior, temporal superior, superior temporal, and superior nasal). AL was positively correlated with inferior temporal VD and negatively correlated with superior nasal VD.
Conclusion And Relevance:
Optical coherence tomography angiography showed moderate-to-good repeatability and reproducibility for papillary and peripapillary perfusion measurements in healthy children. The SSI value affects most of the peripapillary VD, while AL affects only the temporal inferior and nasal superior peripapillary VD.
