Slab-Specific Projection-Resolved Optical Coherence Tomography Angiography for Enhancing En Face Polyp Detection in...

Area of Science:

• Ophthalmology
• Medical Imaging
• Biomedical Engineering

Background:

• Polypoidal choroidal vasculopathy (PCV) diagnosis relies on differentiating polyps from branching vascular networks (BVN).
• Current en face OCTA methods have limitations in accurately detecting and characterizing polyp structures.

Purpose of the Study:

• To evaluate a projection-resolved optical coherence tomography angiography (PR-OCTA) algorithm with a slab-specific strategy for improved polyp detection in PCV.
• To differentiate between polyps and BVN using en face OCTA.

Main Methods:

• A slab-specific PR-OCTA algorithm was applied to 29 PCV patients and 30 neovascular age-related macular degeneration (nAMD) patients.
• Polyps were classified into Type 1 (high-elevated PED, green), Type 2 (low-elevated PED, yellow), and Type 3 (undetectable by OCTA).
• The algorithm was tested for differentiating PCV from typical nAMD.

Main Results:

• The algorithm differentiated Type 1 polyps from BVN on en face OCTA.
• Polyp detection rate for Type 1 polyps improved from 30% to 68% (P = 0.0001).
• A 91% detection rate for Types 1 and 2 polyps was achieved using combined en face and cross-sectional OCTA images. 83% of nAMD patients were correctly classified.

Conclusions:

• The slab-specific PR-OCTA algorithm significantly enhances polyp detection and visualization in PCV.
• This technique allows for rapid diagnosis without the risks associated with dye injections.
• The algorithm aids in differentiating PCV from typical nAMD.