Bruch's Membrane Opening-Based Peripapillary Optical Coherence Tomography Angiography Analysis.

Area of Science:

• Ophthalmology and Medical Imaging

Background:

• Peripapillary optical coherence tomography angiography (OCT-A) vessel density (VD) analysis is challenging due to optic disc demarcation issues.
• Longitudinal VD analysis requires precise pixel alignment across follow-up OCT-A scans to detect inter-visit changes.
• Current methods for peripapillary OCT-A analysis lack consistent reliability for longitudinal studies.

Purpose of the Study:

• To evaluate the reliability of Bruch's membrane opening (BMO)-based peripapillary OCT-A analysis.
• To compare BMO-based analysis with and without anatomical positioning system (APS) implementation against manual analysis.
• To determine the suitability of BMO-based OCT-A analysis for longitudinal studies.

Main Methods:

• Thirty-seven eyes underwent serial OCT-A measurements using Heidelberg OCT II Spectralis.
• Peripapillary OCT-A scans were analyzed using the Erlangen-Angio-Tool (EA-Tool) with APS and BMO-based approaches.
• Analyses included manual, BMO-based, and BMO-based with APS-informed alignment; coefficients of variation (CVs) were calculated.

Main Results:

• Manual VD analysis showed a significant difference between scans (p=0.04), unlike BMO-based and BMO-based with APS methods (p>0.05).
• Coefficients of variation (CVs) for VD were 10.0% (manual), 8.0% (BMO-based), and 8.0% (BMO-based with APS).
• BMO-based approaches, with or without APS, demonstrated superior consistency for peripapillary VD measurements.

Conclusions:

• Integrating Bruch's membrane opening (BMO) and anatomical positioning system (APS) information enhances peripapillary OCT-A analysis reliability.
• BMO-based peripapillary VD analysis, especially with APS, is reliable for longitudinal OCT-A studies.
• This method improves the accuracy of detecting changes in peripapillary vessel density over time.