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Untracht GR, Durkee MS, Zhao M, Kwok-Cheung Lam A, Sikorski BL, Sarunic MV, Andersen PE, Sampson DD, Chen FK, Sampson DM. Towards standardising retinal OCT angiography image analysis with open-source toolbox OCTAVA. Sci Rep 2024; 14:5979. [PMID: 38472220 PMCID: PMC10933365 DOI: 10.1038/s41598-024-53501-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 02/01/2024] [Indexed: 03/14/2024] Open
Abstract
Quantitative assessment of retinal microvasculature in optical coherence tomography angiography (OCTA) images is important for studying, diagnosing, monitoring, and guiding the treatment of ocular and systemic diseases. However, the OCTA user community lacks universal and transparent image analysis tools that can be applied to images from a range of OCTA instruments and provide reliable and consistent microvascular metrics from diverse datasets. We present a retinal extension to the OCTA Vascular Analyser (OCTAVA) that addresses the challenges of providing robust, easy-to-use, and transparent analysis of retinal OCTA images. OCTAVA is a user-friendly, open-source toolbox that can analyse retinal OCTA images from various instruments. The toolbox delivers seven microvascular metrics for the whole image or subregions and six metrics characterising the foveal avascular zone. We validate OCTAVA using images collected by four commercial OCTA instruments demonstrating robust performance across datasets from different instruments acquired at different sites from different study cohorts. We show that OCTAVA delivers values for retinal microvascular metrics comparable to the literature and reduces their variation between studies compared to their commercial equivalents. By making OCTAVA publicly available, we aim to expand standardised research and thereby improve the reproducibility of quantitative analysis of retinal microvascular imaging. Such improvements will help to better identify more reliable and sensitive biomarkers of ocular and systemic diseases.
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Affiliation(s)
- Gavrielle R Untracht
- Department of Health Technology, Technical University of Denmark, 2800, Kongens Lyngby, Denmark
- School of Biosciences, The University of Surrey, Guildford, GU27XH, UK
| | | | - Mei Zhao
- Centre for Myopia Research, School of Optometry, Faculty of Health and Social Science, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China
| | - Andrew Kwok-Cheung Lam
- Centre for Myopia Research, School of Optometry, Faculty of Health and Social Science, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China
| | - Bartosz L Sikorski
- Department of Ophthalmology, Nicolaus Copernicus University, 85-090, Bydgoszcz, Poland
- International Center for Translational Eye Research (ICTER), Institute of Physical Chemistry, Polish Academy of Sciences, Kasprzaka 44/52, 01-224, Warsaw, Poland
| | - Marinko V Sarunic
- Department of Medical Physics and Biomedical Engineering, University College London, London, WC1E6BT, UK
- Institute of Ophthalmology, University College London, London, EC1V2PD, UK
| | - Peter E Andersen
- Department of Health Technology, Technical University of Denmark, 2800, Kongens Lyngby, Denmark
| | - David D Sampson
- School of Computer Science and Electronic Engineering, The University of Surrey, Guildford, GU27XH, UK
| | - Fred K Chen
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute), The University of Western Australia, Perth, WA, 6009, Australia
- Department of Ophthalmology, Royal Perth Hospital, Perth, WA, 6000, Australia
- Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, VIC, 3002, Australia
| | - Danuta M Sampson
- School of Biosciences, The University of Surrey, Guildford, GU27XH, UK.
- Institute of Ophthalmology, University College London, London, EC1V2PD, UK.
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute), The University of Western Australia, Perth, WA, 6009, Australia.
- Department of Optometry, School of Allied Health, The University of Western Australia, Perth, WA, 6009, Australia.
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Bin W. Application of improved image restoration algorithm and depth generation in English intelligent translation teaching system. Soft comput 2023. [DOI: 10.1007/s00500-023-08802-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2023] [Indexed: 09/01/2023]
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Türksever C, Hoffmann L, Hatz K. Peripapillary and macular microvasculature in neovascular age-related macular degeneration in long-term and recently started anti-VEGF therapy versus healthy controls. Front Med (Lausanne) 2023; 9:1080052. [PMID: 36698793 PMCID: PMC9870592 DOI: 10.3389/fmed.2022.1080052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 12/16/2022] [Indexed: 01/12/2023] Open
Abstract
Aim To investigate the peripapillary and macular microvasculature in neovascular age-related macular degeneration (nAMD) in recently started versus long-term anti-vascular endothelial growth factor (VEGF) therapy and healthy controls. Methods Eyes with nAMD treated in a treat-and-extend regimen were assigned to group 1 (<5 injections) or 2 (≥20 injections) whereas group 3 constituted the healthy age-matched controls. Blood flow signals were acquired using PLEX® Elite 9000 swept-source optical coherence tomography angiography (OCTA) of the macular and peripapillary regions. Mean ganglion cell complex (GCC) thickness values were quantified using spectral-domain optical coherence tomography (SD-OCT). Results Including 80 eyes whereof 40 controls, macular superficial perfusion density was significantly reduced in group 1 and 2 compared to controls (p < 0.001; p = 0.010) without a difference between groups 1 and 2. Peripapillary perfusion parameters did not correlate with post-operative intraocular pressure (IOP) or number of anti-VEGF injections. Mean peripapillary flux index was significantly lower in group 2 than in controls (p = 0.023) and significantly decreased in the nasal quadrants for both AMD groups compared to group 3 (p = 0.013; p < 0.001). Mean peripapillary perfusion density was significantly reduced in both AMD groups compared to controls (0.515 ± 0.02 versus 0.556 ± 0.03, p < 0.0001). Conclusion Frequency of anti-VEGF treatment in nAMD and post-operative IOP showed no correlation with peripapillary perfusion parameters, but anti-VEGF treated nAMD patients exhibited partly altered peripapillary perfusion compared to healthy controls. Reduced macular perfusion density of the inner retina in anti-VEGF treated nAMD compared to healthy controls might be discussed as an anti-VEGF treatment effect or a characteristic of nAMD.
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Affiliation(s)
- Cengiz Türksever
- Medical Retina Department, Vista Augenklinik Binningen, Binningen, Switzerland,Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Laura Hoffmann
- Medical Retina Department, Vista Augenklinik Binningen, Binningen, Switzerland,Augenklinik, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Katja Hatz
- Medical Retina Department, Vista Augenklinik Binningen, Binningen, Switzerland,Faculty of Medicine, University of Basel, Basel, Switzerland,*Correspondence: Katja Hatz,
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Pradhan ZS, Sreenivasaiah S, Srinivasan T, Shroff S, Devi S, Rao DAS, Webers CAB, Puttaiah NK, Rao HL. The Importance of Signal Strength Index in Optical Coherence Tomography Angiography: A Study of Eyes with Pseudoexfoliation Syndrome. Clin Ophthalmol 2022; 16:3481-3489. [PMID: 36274675 PMCID: PMC9579007 DOI: 10.2147/opth.s378722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 09/22/2022] [Indexed: 12/02/2022] Open
Abstract
PURPOSE To evaluate the effect of the signal strength index (SSI) on a comparison of the vascular and structural OCT measurements between eyes with pseudoexfoliation syndrome (PXF) and healthy controls of Asian-Indian origin. METHODS In this cross-sectional study, 33 eyes of 33 PXF patients and 40 healthy eyes of 40 controls underwent OCT and OCT angiography (OCTA). Eyes with intraocular pressure (IOP) >21mmHg, glaucomatous disc changes, or any other ocular pathology were excluded. Peripapillary vessel density (VD) and retinal nerve fiber layer (RNFL) thickness were determined from the optic disc scans. Parafoveal VD and ganglion cell complex (GCC) thickness were measured from the macular scans. These parameters were compared between the groups using mixed effect models after adjusting for clinical confounders such as IOP, as well as SSI of the scans. RESULTS The 2 groups were demographically similar. Average RNFL (94µm vs 100µm, p = 0.01) and GCC (91µm vs 95µm, p = 0.03) were thinner in the PXF group compared to controls. The average peripapillary VD appeared lower in the PXF groups compared to controls (58.2% vs 58.8%, p = 0.04), but after adjusting for IOP and SSI, no difference was noted (p = 0.39). After accounting for confounders, parafoveal VD in the PXF group was significantly lower compared to controls (44.3% vs 46.8%, p = 0.008). CONCLUSION Peripapillary RNFL thickness, parafoveal GCC thickness and parafoveal VD were decreased in eyes with PXF when compared to controls. VD measurements are associated with the SSI and, therefore, clinicians and researchers evaluating OCTA scans quantitatively must consider the SSI value during analysis and interpretation.
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Affiliation(s)
- Zia Sultan Pradhan
- Department of Glaucoma, Narayana Nethralaya, Bangalore, India,Correspondence: Zia Sultan Pradhan, Department of Glaucoma, Narayana Nethralaya, 121/C, Chord Road, 1st “R” Block, Rajajinagar, Bangalore, 560010, India, Tel +91 80 66121300, Email
| | | | | | - Sujani Shroff
- Department of Glaucoma, Narayana Nethralaya, Bangalore, India
| | - Sathi Devi
- Department of Glaucoma, Narayana Nethralaya, Bangalore, India
| | | | - Carroll A B Webers
- Department of Ophthalmology, University Eye Clinic Maastricht, University Medical Center, Maastricht, the Netherlands
| | | | - Harsha Laxmana Rao
- Department of Glaucoma, Narayana Nethralaya, Bangalore, India,Department of Ophthalmology, University Eye Clinic Maastricht, University Medical Center, Maastricht, the Netherlands
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Li Q, Gong P, Ho PH, Kennedy BF, Mackey DA, Chen FK, Charng J. Evaluating Distribution of Foveal Avascular Zone Parameters Corrected by Lateral Magnification and Their Associations with Retinal Thickness. OPHTHALMOLOGY SCIENCE 2022; 2:100134. [PMID: 36249684 PMCID: PMC9560651 DOI: 10.1016/j.xops.2022.100134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 02/22/2022] [Accepted: 02/23/2022] [Indexed: 11/18/2022]
Abstract
Purpose To examine the distribution of foveal avascular zone (FAZ) parameters, with and without correction for lateral magnification, in a large cohort of healthy young adults. Design Cross-sectional, observational cohort study. Participants A total of 504 healthy adults, 27 to 30 years of age. Methods Participants underwent a comprehensive ophthalmic examination including axial length measurement and OCT angiography (OCTA) imaging of the macula. OCT angiography images of combined superficial and deep retinal vessel plexuses were processed via a custom software to extract foveal avascular zone area (FAZA) and foveal density-300 (FD-300), the vessel density in a 300-μm wide annulus surrounding the FAZ, with and without correction for lateral magnification. Bland–Altman analyses were performed to examine the effect of lateral magnification on FAZA and FD-300, as well as to evaluate the interocular agreement in both parameters. Linear mixed-effects models were used to examine the relationship between retinal thicknesses and OCTA parameters. Main Outcome Measures The FAZA and FD-300, corrected for lateral magnification. Results The mean (standard deviation [SD]) of laterally corrected FAZA and FD-300 was 0.22 mm2 (0.10 mm2) and 51.9% (3.2%), respectively. Relative to uncorrected data, 55.6% of corrected FAZA showed a relative change > 5%, whereas all FD-300 changes were within 5%. There was good interocular symmetry (mean right eye–left eye difference, 95% limits of agreement [LoA]) in both FAZA (0.006 mm2, -0.05 mm2, to 0.07 mm2) and FD-300 (-0.05%, -5.39%, to 5.30%). There were significant negative associations between central retinal thickness and FAZA (β = -0.0029), as well as between central retinal thickness and FD-300 (β = -0.044), with the relationships driven by inner, not outer, retina. Conclusions We reported lateral magnification adjusted normative values for FAZA and FD-300 in a large cohort of young, healthy eyes. Clinicians should strongly consider accounting for lateral magnification when evaluating FAZA. Good interocular agreement in FAZA and FD-300 suggests the contralateral eye can be used as control data.
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Affiliation(s)
- Qiang Li
- Centre of Ophthalmology and Visual Science (incorporating Lions Eye Institute), The University of Western Australia, Perth, Australia
| | - Peijun Gong
- BRITElab, Harry Perkins Institute of Medical Research, Centre for Medical Research, QEII Medical Centre, The University of Western Australia, Perth, WA, Australia
- Department of Electrical, Electronic & Computer Engineering, School of Engineering, The University of Western Australia, Perth, WA, Australia
| | - Phuoc Hao Ho
- BRITElab, Harry Perkins Institute of Medical Research, Centre for Medical Research, QEII Medical Centre, The University of Western Australia, Perth, WA, Australia
- Department of Electrical, Electronic & Computer Engineering, School of Engineering, The University of Western Australia, Perth, WA, Australia
| | - Brendan F. Kennedy
- BRITElab, Harry Perkins Institute of Medical Research, Centre for Medical Research, QEII Medical Centre, The University of Western Australia, Perth, WA, Australia
- Department of Electrical, Electronic & Computer Engineering, School of Engineering, The University of Western Australia, Perth, WA, Australia
- Australian Research Council Centre for Personalised Therapeutics Technologies, Melbourne, Australia
| | - David A. Mackey
- Centre of Ophthalmology and Visual Science (incorporating Lions Eye Institute), The University of Western Australia, Perth, Australia
- Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Australia
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
| | - Fred K. Chen
- Centre of Ophthalmology and Visual Science (incorporating Lions Eye Institute), The University of Western Australia, Perth, Australia
- Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Australia
- Department of Ophthalmology, Royal Perth Hospital, Perth, Australia
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
- Correspondence: Fred K. Chen, FRANZCO, PhD, Lions Eye Institute, Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, WA 6009, Australia.
| | - Jason Charng
- Centre of Ophthalmology and Visual Science (incorporating Lions Eye Institute), The University of Western Australia, Perth, Australia
- Department of Optometry, School of Allied Health, The University of Western Australia, Perth, Australia
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Sampson DM, Dubis AM, Chen FK, Zawadzki RJ, Sampson DD. Towards standardizing retinal optical coherence tomography angiography: a review. LIGHT, SCIENCE & APPLICATIONS 2022; 11:63. [PMID: 35304441 PMCID: PMC8933532 DOI: 10.1038/s41377-022-00740-9] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 02/01/2022] [Accepted: 02/14/2022] [Indexed: 05/11/2023]
Abstract
The visualization and assessment of retinal microvasculature are important in the study, diagnosis, monitoring, and guidance of treatment of ocular and systemic diseases. With the introduction of optical coherence tomography angiography (OCTA), it has become possible to visualize the retinal microvasculature volumetrically and without a contrast agent. Many lab-based and commercial clinical instruments, imaging protocols and data analysis methods and metrics, have been applied, often inconsistently, resulting in a confusing picture that represents a major barrier to progress in applying OCTA to reduce the burden of disease. Open data and software sharing, and cross-comparison and pooling of data from different studies are rare. These inabilities have impeded building the large databases of annotated OCTA images of healthy and diseased retinas that are necessary to study and define characteristics of specific conditions. This paper addresses the steps needed to standardize OCTA imaging of the human retina to address these limitations. Through review of the OCTA literature, we identify issues and inconsistencies and propose minimum standards for imaging protocols, data analysis methods, metrics, reporting of findings, and clinical practice and, where this is not possible, we identify areas that require further investigation. We hope that this paper will encourage the unification of imaging protocols in OCTA, promote transparency in the process of data collection, analysis, and reporting, and facilitate increasing the impact of OCTA on retinal healthcare delivery and life science investigations.
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Affiliation(s)
- Danuta M Sampson
- Surrey Biophotonics, Centre for Vision, Speech and Signal Processing and School of Biosciences and Medicine, The University of Surrey, Guildford, GU2 7XH, UK.
| | - Adam M Dubis
- NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Trust and UCL Institute of Ophthalmology, London, EC1V 2PD, UK
| | - Fred K Chen
- Centre for Ophthalmology and Visual Science (incorporating Lions Eye Institute), The University of Western Australia, Nedlands, Western Australia, 6009, Australia
- Department of Ophthalmology, Royal Perth Hospital, Perth, Western Australia, 6000, Australia
- Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Victoria, 3002, Australia
| | - Robert J Zawadzki
- Department of Ophthalmology & Vision Science, University of California Davis, Sacramento, CA, 95817, USA
| | - David D Sampson
- Surrey Biophotonics, Advanced Technology Institute, School of Physics and School of Biosciences and Medicine, University of Surrey, Guildford, Surrey, GU2 7XH, UK
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Comba ÖB, Pehlivanoğlu S, Albayrak S, Karakaya M, Bayraktar Z, Bayraktar Ş. Optical coherence tomography-signal strength index following trifocal and monofocal intraocular lens implantation. Photodiagnosis Photodyn Ther 2021; 36:102606. [PMID: 34710616 DOI: 10.1016/j.pdpdt.2021.102606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 10/07/2021] [Accepted: 10/22/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE To evaluate the influence of trifocal and monofocal intraocular lens implantation on the optical coherence tomography-signal strength index values obtained during macular and peripapillary scanning. METHOD Study group included 60 eyes of 60 patients with intraocular lens (Acriva BB UD 613 monofocal in 30 eyes and Acriva Trinova UD trifocal in 30 eyes) implantation after uneventful phacoemulsification. Thirty eyes of 30 healthy subjects without any intraocular surgery were selected as the control group. Eyes with best corrected visual acuity less than 20/20 due to any media opacity, high refractive errors excluded. Macular and retinal nerve fiber layer scans were generated by optical coherence tomography after pupillary dilation. Intergroup comparisons of signal strength index values of the macular and peripapillary scans were performed between eyes implanted with two different intraocular lenses and control group. RESULTS The mean signal strength index of the peripapillary and macular scans obtained in the eyes implanted with both monofocal and trifocal intraocular lenses were statistically less than the control group (p < 0.05, for all). SSI's of macular and peripapillary scans recorded from the eyes implanted with either monofocal or trifocal intraocular lenses were not statistically different from each other (p = 0.957 and p = 0.877, respectively). CONCLUSION In the present study despite different intraocular lenses properties, the image quality values were not found to be lower in eyes with trifocal sinusoidal intraocular lenses implantation compared to monofocal intraocular lenses during macular and peripapillary optical coherence tomography scans.
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Affiliation(s)
| | | | - Sinan Albayrak
- Yeniyüzyıl University Gaziosmanpaşa Hospital, Istanbul, Turkey.
| | | | | | - Şükrü Bayraktar
- Yeniyüzyıl University Gaziosmanpaşa Hospital, Istanbul, Turkey
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Sung SM, Kim JH, Lee KW, Kang HG. Analysis of Macular Capillary Plexuses after Cataract Surgery via Optical Coherence Tomography Angiography. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2020. [DOI: 10.3341/jkos.2020.61.11.1288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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