Repeatability and Reproducibility of Superficial Macular Retinal Vessel Density Measurements Using Optical Coherence Tomography Angiography En Face Images
Repeatability and Reproducibility of Superficial Macular Retinal Vessel Density Measurements Using Optical Coherence Tomography Angiography En Face Images
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DOI：
10.1001/jamaophthalmol.2017.3431
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发表时间：
2017-10-01
影响因子：
8.1
通讯作者：
Sadda, Srinivas R.
中科院分区：
文献类型：
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作者：
Lei, Jianqin;Durbin, Mary K.;Sadda, Srinivas R.
光学相干断层血管造影（OCTA）定量指标的可重复性和再现性必须在这些数据可以在临床研究和实践中自信地解释之前进行评估。目的评价octa衍生视网膜血管定量指标的重复性和再现性。在这项横断面研究中，21名健康志愿者（42只眼）和22名视网膜疾病患者（22只眼），包括14名年龄相关性黄斑变性患者、3名视网膜前膜患者、2名糖尿病视网膜病变患者、2名近视黄斑变性患者和1名视网膜静脉闭塞患者。参与者于2016年9月1日至11月31日招募。每只眼睛用3种仪器进行3次重复扫描，共9次采集。眼睛被随机分配以3 × 3毫米或6 × 6毫米的模式扫描。如果任何采集信号强度低于7，则将眼睛排除在后续分析之外。通过类内相关系数（ICC）和变异系数评估重复性（定义为设备内测量的一致性）和再现性（定义为同一类型设备之间的一致性）。所有的眼睛都用三种不同的设备进行扫描。主要观察结果及测量视网膜浅表血管的血管长度密度（VLD）和灌注密度（PD）。结果共有21名健康志愿者（8名男性，13名女性，平均年龄36岁）和22名视网膜疾病患者（15名男性，7名女性，平均年龄79岁）接受了评估。其中，42只正常眼睛中的40只和22只患有视网膜疾病的眼睛中的15只符合信号强度标准，并被纳入本分析。连续3次扫描的ICC范围为VLD的0.82 ~ 0.98，PD的0.83 ~ 0.95。VLD的变异系数（CV）为2.2% ~ 5.9%，PD为2.4% ~ 5.9%。为了重现性，所有组的ICC范围为0.62 ~ 0.95，CV小于6%。一致性最高的是内环的3 × 3-mm模式（ICC范围，0.92 [95% CI, 0.85-0.96]至0.96 [95% CI, 0.93-0.98]）和外环的6 × 6-mm模式（ICC范围，0.93 [95% CI, 0.86-0.97]至0.96 [95% CI, 0.92-0.98]）。OCTA图像可获得视网膜浅表血管的血管长度、密度和PD，具有高水平的重复性和再现性，但随扫描方式和位置的不同而变化。
IMPORTANCE The repeatability and reproducibility of quantitative metrics from optical coherence tomographic angiography (OCTA) must be assessed before these data can be confidently interpreted in clinical research and practice.OBJECTIVE To evaluate the repeatability and reproducibility of OCTA-derived retinal vascular quantitative metrics.DESIGN, SETTING AND PARTICIPANTS In this cross-sectional study, 21 healthy volunteers (42 eyes) and 22 patients with retinal disease (22 eyes), including 14 with age-related macular degeneration, 3 with epiretinal membrane, 2 with diabetic retinopathy, 2 with myopic macular degeneration, and 1 with retinal vein occlusion, were enrolled. Participants were recruited from September 1 through November 31, 2016. Each eye underwent 3 repeated scans with 3 instruments for a total of 9 acquisitions. Eyes were randomly assigned to scanning with a 3 x 3-mm or 6 x 6-mm pattern. Eyes were excluded from subsequent analysis if any acquisition had a signal strength of less than 7. Repeatability (defined as the agreement in measurements within a device) and reproducibility (defined as the agreement between devices of the same type) were assessed by intraclass correlation coefficient (ICC) and coefficient of variation. EXPOSURES All eyes underwent scanning using 3 separate devices.MAIN OUTCOMES AND MEASURES Vessel length density (VLD) and perfusion density (PD) of the superficial retinal vasculature.RESULTS A total of 21 healthy volunteers (8 men and 13 women; mean [SD] age, 36 [6] years) and 22 patients with retinal disease (15 men and 7 women; mean [SD] age, 79 [9] years) underwent evaluation. Of these, 40 of 42 normal eyes and 15 of 22 eyes with retinal disease met signal strength criteria and were included in this analysis. The ICC among the 3 consecutive scans ranged from 0.82 to 0.98 for VLD and from 0.83 to 0.95 for PD. The coefficient of variation (CV) ranged from 2.2% to 5.9% for VLD and from 2.4% to 5.9% for PD. For reproducibility, the ICC ranged from 0.62 to 0.95 and the CV was less than 6% in all groups. The agreement was highest for the 3 x 3-mm pattern in the inner ring (ICC range, 0.92 [95% CI, 0.85-0.96] to 0.96 [95% CI, 0.93-0.98]) and 6 x 6-mm pattern in the outer ring (ICC range, 0.93 [95% CI, 0.86-0.97] to 0.96 [95% CI, 0.92-0.98]).CONCLUSIONS AND RELEVANCE Vessel length density and PD of the superficial retinal vasculature can be obtained from OCTA images with high levels of repeatability and reproducibility but can vary with scan pattern and location.