Multi-Center Repeatability of Macular Capillary Perfusion Density Using Optical Coherence Tomography Angiography

• Published in: Clinical ophthalmology (Auckland, N.Z.) Vol. 16; pp. 3069 - 3078
• Main Authors: Jiang, Hong, Simms, Ava-Gaye, Sadaghiani, Shokufeh, Jiang, Yu You, Morgan, Jessica IW, Aguirre, Geoffrey K, Pattany, Pradip M, Detre, John A, Wang, Jianhua
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 01.01.2022; Taylor & Francis Ltd; Dove; Dove Medical Press
• Subjects: Agreements; Angiography; Diabetic retinopathy; Exports; Fractals; Image processing; Medical imaging; multi-center study; optical coherence tomography angiography; Original Research; repeatability; Reproducibility; retinal capillary perfusion density; Software; Tomography; Florida; United States > US; repeatability; retinal capillary perfusion density; multi-center study; optical coherence tomography angiography
• ISSN: 1177-5483; 1177-5467; 1177-5483
• DOI: 10.2147/OPTH.S383770

This study was to determine the test-retest repeatability in quantifying macular capillary perfusion density (CPD, expressed as fractal dimension) using optical coherence tomography angiography (OCTA) in a multi-center setting. OCTA data were obtained in self-reported healthy subjects from Bascom Palmer Eye Institute at the University of Miami (UM, N = 18) and the University of Pennsylvania (UPenn, N = 22). The right eye of each subject was imaged twice at the first visit and then again at an interval of one week to assess intra-visit and inter-visit repeatability. The macular area of the OCTA-derived capillary perfusion density (OCTA-CPD) was analyzed by custom-made image processing and fractal analysis software. Fractal analysis was performed on the skeletonized microvascular network to yield OCTA-CPD by box-counting to the fractal dimension (Dbox) in the superficial vascular plexus (SVP). Repeatability was assessed by three measures: within-subject standard deviation (Sw), coefficient of variation (CoV) of repeated measures, and intraclass correlation coefficient (ICC). OCTA-CPD from both sites (UM and UPENN) showed good to excellent intra-visit repeatability, as demonstrated by the Sw ≤0.004, CoVs ≤0.23%, and ICCs ≥0.61. Similarly, both sites had good to excellent inter-visit repeatability, as shown by the Sw ≤0.005, CoVs ≤0.28%, and ICCs ≥0.61. The Bland-Altman plots of the intra-visit and inter-visit measurements showed excellent agreements between the paired measurements with minimal biases. Our data showed that comparable high repeatability of OCTA-CPD can be achieved in both research sites using the same device, scan protocol, and image analysis.