A practical guide to optical coherence tomography angiography interpretation
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(2020) 6:55 Greig et al. Int J Retin Vitr https://doi.org/10.1186/s40942-020-00262-9
Open Access
REVIEW
A practical guide to optical coherence tomography angiography interpretation Eugenia Custo Greig1,2, Jay S. Duker1 and Nadia K. Waheed1*
Abstract Background: Optical coherence tomography angiography (OCTA) can image the retinal vasculature in vivo, without the need for contrast dye. This technology has been commercially available since 2014, however, much of its use has been limited to the research setting. Over time, more clinical practices have adopted OCTA imaging. While countless publications detail OCTA’s use for the study of retinal microvasculature, few studies outline OCTA’s clinical utility. Body: This review provides an overview of OCTA imaging and details tips for successful interpretation. The review begins with a summary of OCTA technology and artifacts that arise from image acquisition. New methods and best practices to prevent image artifacts are discussed. OCTA has the unique ability among retinovascular imaging modalities to individually visualize each retinal plexus. Slabs offered in standard OCTA devices are reviewed, and clinical uses for each slab are outlined. Lastly, the use of OCTA for the clinical interpretation of retinal pathology, such as diabetic retinopathy and age-related macular degeneration, is discussed. Conclusion: OCTA is evolving from a scientific tool to a clinical imaging device. This review provides a toolkit for successful image interpretation in a clinical setting. Keywords: Optical coherence tomography angiography, Interpretation, Artifacts Background Optical coherence tomography angiography (OCTA) first became commercially available in 2014 [1]. This technology allowed for the visualization of retinal microvasculature in vivo. Prior to OCTA, fluorescein angiography (FA) and indocyanine green angiography (ICGA) were the mainstay modalities for retinovascular visualization. These imaging modalities generated a 2-dimensional en face view of the retinal vasculature and did not allow for the individual visualization of retinal capillary plexuses. OCTA offered in vivo visualization of the retinal microvasculature in a depth-resolved fashion, without the need for time-consuming dye administration.
*Correspondence: [email protected] 1 New England Eye Center, Tufts Medical Center, 800 Washington Street, Box 450, Boston, MA 02111, USA Full list of author information is available at the end of the article
Prior to its commercial release, OCTA was available as a research tool. Investigational groups explored the utility of OCTA in a wide range of ocular pathologies including age related macular degeneration (AMD), diabetic retinopathy (DR), and uveitis [2–8]. A large body of literature emerged to describe vascular findings on OCTA. Though scientifically novel and relevant to the understanding of ocular pathophysiology, these studies often reference language and metrics that remain inaccessible to clinical ophthalmologists. This review will offer a basic toolkit fo
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