Optical coherence tomography angiography-derived flow density: a review of the influencing factors
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REVIEW ARTICLE
Optical coherence tomography angiography-derived flow density: a review of the influencing factors Viktoria C. Brücher 1
&
Jens J. Storp 1 & Nicole Eter 1 & Maged Alnawaiseh 1
Received: 14 May 2019 / Revised: 18 November 2019 / Accepted: 21 November 2019 # Springer-Verlag GmbH Germany, part of Springer Nature 2019
Abstract Research interest in the possibility of quantifying macular and optic nerve head perfusion through optical coherence tomography angiography (OCTA) is rapidly advancing. Numerous scientific trials have furthered our understanding of the capabilities and the limitations of this novel technology, while applying OCTA to various ocular pathologies. In recent years, different parameters such as age, gender, intraocular pressure, spherical equivalent, physical activity, systemic diseases, and medication have been shown to have a significant impact on quantitative OCTA metrics. Since OCTA is likely to remain a “hot topic” in the near future, it is crucial to be aware of influencing factors in order to ensure correct interpretation of imaging results. This article reviews the factors currently known to influence flow density (FD) as measured by OCTA in healthy eyes. Keywords Optical coherence tomography angiography . OCTA . Flow density . Influencing factor . Retinal microcirculation
Introduction Assessment of ocular vessel condition has been of great significance in ophthalmic practice ever since the first fundoscopy was performed. Since then, numerous advances have been made in ocular diagnostic technology. Optical coherence tomography (OCT) angiography (OCTA) has been one of the most intensively investigated advances in ocular diagnostics in recent years [1–3]. OCTA allows noninvasive visualization of the retinal vasculature and pathological neovascularization. Moreover, OCTA can quantify the blood flow of the retina, optic nerve head (ONH), and choriocapillaris [4], translating this data into “flow density” (FD). The retinal FD represents the proportion of vascularized to non-vascularized areas in an OCTA enface image. The enface image is generated by transferring the segmented three-dimensional OCTA flow data into a two-dimensional image, trading depth information for the purpose of simplifying data representation [5]. With no need for intravenous dye, rapid scanning times and yet high reproducibility as well as repeatability [6–8], it has
attracted great interest among ophthalmologists, researchers, and patients alike. To date, application of OCTA has been described in healthy eyes and in different ocular and systemic diseases, as well as in animal models. A wide range of factors are known to influence OCTA metrics, including ocular diseases, systemic diseases, and variable parameters (e.g., age, gender, axial length of the eye, systemic, and local medication) [4, 5, 9–27]. Considering the advantages of OCTA in monitoring the retinal microcirculation and given that it is likely to remain a field of great interest in the near future, better knowledge of the factors influencing O
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