Related Experiment Video
Updated: May 24, 2026
Retinal Vascular Reactivity as Assessed by Optical Coherence Tomography Angiography
Published on: March 26, 2020
Efficacy of En Face Optical Coherence Tomography Minimum Intensity Projection in Evaluating Inflammatory Retinal
Yuka Mizuno1, Sunil K Srivastava2, Victor Bellanda1
1From the Uveitis Center of Excellence (Y.M., S.K.S., Y.B., C.C., G.C.S.B., D.S., E.S., K.B., S.S.), Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Purpose:
To evaluate the diagnostic performance of en face optical coherence tomography (OCT) using minimum intensity projection (MIP) to detect fluorescein angiography (FA)-defined inflammatory retinal vascular changes.
Design:
Prospective, single-center reliability and validity analysis.
Participants:
A total of 318 eyes from 177 patients with uveitis who underwent same-day ultra-widefield FA and macula-centered 12 × 12-mm spectral-domain OCT imaging.
Methods:
Inflammatory retinal vascular changes were defined as vascular leakage and/or vascular wall staining on late-phase FA. En face OCT images were generated using MIP slabs spanning 10% to 70% of total retinal thickness. MIP images and retinal thickness maps were independently graded in a masked fashion and compared with FA as the reference standard. Diagnostic performance metrics were calculated. Inter-grader agreement was assessed using Cohen's κ coefficient.
Main Outcome Measures:
Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), F1 score, and inter-grader agreement for detecting FA-defined inflammatory retinal vascular changes.
Results:
FA demonstrated inflammatory retinal vascular changes in 208 of 318 eyes (65%), including 94 with activity within the central 12 × 12-mm field and 114 with activity confined to the peripheral retina. Overall, MIP en face OCT achieved a sensitivity of 0.82, specificity of 0.55, PPV of 0.77, NPV of 0.62, and F1 score of 0.80 for detecting FA-defined inflammatory retinal vascular changes. Compared with retinal thickness maps, MIP demonstrated substantially higher sensitivity (0.82 vs 0.50) and F1 score (0.80 vs 0.57). MIP en face OCT identified FA-positive eyes with higher detection rates than retinal thickness maps for both central activity (98% vs 60%) and peripheral-only activity (68% vs 42%). Inter-grader agreement was higher for MIP images (κ = 0.75) than for thickness maps (κ = 0.37). In a subset of eyes with longitudinal follow-up, MIP positivity preceded or persisted beyond changes in FA leakage.
Conclusions:
En face OCT using MIP demonstrated high sensitivity for detecting FA-defined inflammatory retinal vascular changes. Although not a replacement for FA, this approach may provide a noninvasive adjunct for clinical assessment and longitudinal evaluation of uveitic disease.
