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Anvari P, Najafi A, Mirshahi R, Sardarinia M, Ashrafkhorasani M, Kazemi P, Aghai G, Habibi A, Falavarjani KG. Comparison of Superficial and Deep Foveal Avascular Zone Area in Healthy Subjects Using Two Spectral Domain Optical Coherence Tomography Angiography Devices. JOVR [Internet]. 2020Oct.25 [cited 2024Apr.19];15(4):517–523. Available from: https://knepublishing.com/index.php/JOVR/article/view/7791
https://doi.org/10.18502/jovr.v15i4.7791
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authors
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Pasha Anvari
Pasha Anvari
Eye Research Center, The Five Senses Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
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Amin Najafi
Amin Najafi
Eye Research Center, The Five Senses Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
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Reza Mirshahi
Reza Mirshahi
Eye Research Center, The Five Senses Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
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Mahsa Sardarinia
Mahsa Sardarinia
Eye Research Center, The Five Senses Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
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Maryam Ashrafkhorasani
Maryam Ashrafkhorasani
Eye Research Center, The Five Senses Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
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Pegah Kazemi
Pegah Kazemi
Eye Research Center, The Five Senses Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
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Gholamhoseyn Aghai
Gholamhoseyn Aghai
Eye Research Center, The Five Senses Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
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Abbas Habibi
Abbas Habibi
Eye Research Center, The Five Senses Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
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Khalil Ghasemi Falavarjani
Khalil Ghasemi Falavarjani
Eye Research Center, The Five Senses Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
Published Date
- Oct 25, 2020
Comparison of Superficial and Deep Foveal Avascular Zone Area in Healthy Subjects Using Two Spectral Domain Optical Coherence Tomography Angiography Devices
Abstract
Purpose: To compare the area of the foveal avascular zone (FAZ) in the superficial and deep retinal layers using two different spectral-domain optical coherence tomography angiography (OCTA) devices.
Methods: A cross-sectional comparative study was conducted to obtain macular OCTA images from healthy subjects using Optovue RTVue XR Avanti (Optovue, Inc, Fremont, CA) and Spectralis HRA+OCTA (Heidelberg Engineering, Heidelberg, Germany). Two independent trained graders measured the FAZ area using automated slab segmentation. The FAZ area in the superficial and deep retinal layers were compared.
Results: Twenty-three eyes of 23 subjects were included. The graders agreement was excellent (>0.86) for all measurements. The mean FAZ area was significantly larger at the superficial retinal layer as compared to the deep retinal layer on both devices (0.31 ± 0.08 mm2 vs 0.26 ± 0.08 mm2 in Optovue and 0.55 ± 0.16 mm2 vs 0.36 ± 0.13 mm2 in Spectralis, both P < 0.001). The mean FAZ area was significantly greater in the superficial and deep retinal layers using Spectralis as compared to Optovue measurements (P < 0.001 for both comparisons).
Conclusion: In contrast to previous reports, the FAZ area was larger in the superficial retina as compared to deep retinal layers using updated software versions. Measurements from different devices cannot be used interchangeably.
Keywords:
Fovea Avascular Zone, Optical Coherence Tomography Angiography, Optovue, Spectraldomain, Spectralis
References
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2. Balaratnasingam C, Inoue M, Ahn S, McCann J, Dhrami- Gavazi E, Yannuzzi LA, et al. Visual acuity is correlated with the area of the foveal avascular zone in diabetic retinopathy and retinal vein occlusion. Ophthalmology 2016;123:2352–2367. Retrieved from: https://doi.org/10. 1016/j.ophtha.2016.07.008.
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4. De Salles MC, Kvanta A, Amrén U, Epstein D. Optical coherence tomography angiography in central retinal vein occlusion: correlation between the foveal avascular zone and visual acuity. Investig Ophthalmol Vis Sci 2016;57:OCT242–OCT246. Retrieved from: https://doi. org/10.1167/iovs.15-18819.
5. Khadamy J, Abri Aghdam K, Falavarjani KG. An update on optical coherence tomography angiography in diabetic retinopathy. J Ophthalmic Vis Res 2018;13:487–497. Retrieved from: https://doi.org/10.4103/jovr.jovr_57_18.
6. Kotsolis AI, Killian FA, Ladas ID, Yannuzzi LA. Fluorescein angiography and optical coherence tomography concordance for choroidal neovascularisation in multifocal choroidtis. Br J Ophthalmol 2010;94:1506–1508. Retrieved from: https://doi.org/10.1136/bjo.2009.159913.
7. Novotny HR, Alvis DL. A method of photographing fluorescence in circulating blood in the human retina. Circulation 1961;24:82–86.
8. Stanga PE, Lim JI, Hamilton P. Indocyanine green angiography in chorioretinal diseases: indications and interpretation: an evidence-based update. Ophthalmology 2003;110:15–21. Retrieved from: https://doi.org/10.1016/ S0161-6420(02)01563-4.
9. Musa F, Muen WJ, Hancock R, Clark D. Adverse effects of fluorescein angiography in hypertensive and elderly patients. Acta Ophthalmol Scand 2006;84:740– 742. Retrieved from: https://doi.org/10.1111/j.1600-0420. 2006.00728.x.
10. Spaide RF, Klancnik JM, Cooney MJ. Retinal vascular layers imaged by fluorescein angiography and optical coherence tomography angiography. JAMA Ophthalmol 2015;133:45. Retrieved from: https://doi.org/10.1001/jamaophthalmol.2014.3616.
11. Kashani AH, Chen CL, Gahm JK, Zheng F, Richter GM, Rosenfeld PJ, et al. Optical coherence tomography angiography: a comprehensive review of current methods and clinical applications. Prog Retin Eye Res 2017;60:66– 100. Retrieved from: https://doi.org/10.1016/j.preteyeres. 2017.07.002.
12. Shahlaee A, Pefkianaki M, Hsu J, Ho AC. Measurement of foveal avascular zone dimensions and its reliability in healthy eyes using optical coherence tomography angiography. Am J Ophthalmol 2016;161:50–55e1. Retrieved from: https://doi.org/10.1016/j.ajo.2015.09.026.
13. Falavarjani KG. Optical coherence tomography angiography of the retina and choroid; current applications and future directions. J Curr Ophthalmol 2017;29:1–4.
14. Carpineto P, Mastropasqua R, Marchini G, Toto L, Di Nicola M, Di Antonio L. Reproducibility and repeatability of foveal avascular zone measurements in healthy subjects by optical coherence tomography angiography. Br J Ophthalmol 2016;100:671–676. Retrieved from: https://doi. org/10.1136/bjophthalmol-2015-307330.
15. Spaide RF, Curcio CA. Evaluation of segmentation of the superficial and deep vascular layers of the retina by optical coherence tomography angiography instruments in normal eyes. JAMA Ophthalmol 2017;135:259–262. Retrieved from: https://doi.org/10.1001/jamaophthalmol.2016.5327.
16. Rommel F, Siegfried F, Kurz M, Brinkmann MP, Rothe M, Rudolf M, et al. Impact of correct anatomical slab segmentation on foveal avascular zone measurements by optical coherence tomography angiography in healthy adults. J Curr Ophthalmol 2018;30:156–160. Retrieved from: https://doi.org/10.1016/j.joco.2018.02.001.
17. Corvi F, Pellegrini M, Erba S, Cozzi M, Staurenghi G, Giani A. Reproducibility of vessel density, fractal dimension, and foveal avascular zone using 7 different optical coherence tomography angiography devices. Am J Ophthalmol 2018;186:25–31. Retrieved from: https://doi.org/10.1016/j. ajo.2017.11.011.
18. Al-Sheikh M, Falavarjani KG, Tepelus TC, Sadda SR. Quantitative comparison of swept-source and spectraldomain OCT angiography in healthy eyes. Ophthalmic Surg Lasers Imag Retin 2017;48:385–391. Retrieved from: https://doi.org/10.3928/23258160-20170428-04.
19. Samara WA, Say EAT, Khoo CTL, Higgins TP, Magrath G, Ferenczy S, et al. Correlation of foveal avascular zone size with foveal morphology in normal eyes using optical coherence tomography angiography. Retina 2015;35:2188–2195. Retrieved from: https://doi.org/10. 1097/IAE.0000000000000847.
20. Magrath GN, Say EAT, Sioufi K, Ferenczy S, Samara WA, Shields CL. Variability in foveal avascular zone and capillary density using optical coherence tomography angiography machines in healthy eyes. Retina 2017;37:2102–2111.
21. Pilotto E, Frizziero L, Crepaldi A, Della Dora E, Deganello D, Longhin E, et al. Repeatability and reproducibility of foveal avascular zone area measurement on normal eyes by different optical coherence tomography angiography instruments. Ophthalmic Res 2018;58:4847. Retrieved from: https://doi.org/10.1159/000485463.
22. Coscas F, Sellam A, Glacet-Bernard A, Jung C, Goudot M, Miere A, et al. Normative data for vascular density in superficial and deep capillary plexuses of healthy adults assessed by optical coherence tomography angiography. Investig Ophthalmol Vis Sci 2016;57:OCT211–223. Retrieved from: https://doi.org/10.1167/iovs.15-18793.
23. Ghassemi F, Fadakar K, Bazvand F, Mirshahi R, Mohebbi M, Sabour S. The quantitative measurements of vascular density and flow areas of macula using optical coherence tomography angiography in normal volunteers. Ophthalmic Surg Lasers Imag Retin 2017;48:478–486.
24. Mihailovic N, Brand C, Lahme L, Schubert F, Bormann E, Eter N, et al. Repeatability, reproducibility and agreement of foveal avascular zone measurements using three different optical coherence tomography angiography devices. PLoS One 2018;13:e0206045. Retrieved from: https://doi.org/10.1371/journal.pone.0206045.
25. Falavarjani K, Shenazandi H, Naseri D, Anvari P, Kazemi P, Aghamohammadi F, et al. Foveal avascular zone and vessel density in healthy subjects: An optical coherence tomography angiography study. J Ophthalmic Vis Res 2018;13:260. Retrieved from: https://doi.org/10.4103/jovr. jovr_173_17.
26. Falavarjani KG, Shenazandi H, Naseri D, Anvari P, Kazemi P, Aghamohammadi F, et al. Foveal avascular zone and vessel density in healthy subjects: an optical coherence tomography angiography study. J Ophthalmic Vis Res 2018;13:260–265. Retrieved from: https://doi.org/10.4103/ jovr.jovr_173_17.
2. Balaratnasingam C, Inoue M, Ahn S, McCann J, Dhrami- Gavazi E, Yannuzzi LA, et al. Visual acuity is correlated with the area of the foveal avascular zone in diabetic retinopathy and retinal vein occlusion. Ophthalmology 2016;123:2352–2367. Retrieved from: https://doi.org/10. 1016/j.ophtha.2016.07.008.
3. Takase N, Nozaki M, Kato A, Ozeki H, Yoshida M, Ogura Y. Enlargement of foveal avascular zone in diabetic eyes evaluated by en face optical coherence tomography angiography. Retina 2015;35:2377–2383. Retrieved from: https://doi.org/10.1097/IAE.0000000000000849.
4. De Salles MC, Kvanta A, Amrén U, Epstein D. Optical coherence tomography angiography in central retinal vein occlusion: correlation between the foveal avascular zone and visual acuity. Investig Ophthalmol Vis Sci 2016;57:OCT242–OCT246. Retrieved from: https://doi. org/10.1167/iovs.15-18819.
5. Khadamy J, Abri Aghdam K, Falavarjani KG. An update on optical coherence tomography angiography in diabetic retinopathy. J Ophthalmic Vis Res 2018;13:487–497. Retrieved from: https://doi.org/10.4103/jovr.jovr_57_18.
6. Kotsolis AI, Killian FA, Ladas ID, Yannuzzi LA. Fluorescein angiography and optical coherence tomography concordance for choroidal neovascularisation in multifocal choroidtis. Br J Ophthalmol 2010;94:1506–1508. Retrieved from: https://doi.org/10.1136/bjo.2009.159913.
7. Novotny HR, Alvis DL. A method of photographing fluorescence in circulating blood in the human retina. Circulation 1961;24:82–86.
8. Stanga PE, Lim JI, Hamilton P. Indocyanine green angiography in chorioretinal diseases: indications and interpretation: an evidence-based update. Ophthalmology 2003;110:15–21. Retrieved from: https://doi.org/10.1016/ S0161-6420(02)01563-4.
9. Musa F, Muen WJ, Hancock R, Clark D. Adverse effects of fluorescein angiography in hypertensive and elderly patients. Acta Ophthalmol Scand 2006;84:740– 742. Retrieved from: https://doi.org/10.1111/j.1600-0420. 2006.00728.x.
10. Spaide RF, Klancnik JM, Cooney MJ. Retinal vascular layers imaged by fluorescein angiography and optical coherence tomography angiography. JAMA Ophthalmol 2015;133:45. Retrieved from: https://doi.org/10.1001/jamaophthalmol.2014.3616.
11. Kashani AH, Chen CL, Gahm JK, Zheng F, Richter GM, Rosenfeld PJ, et al. Optical coherence tomography angiography: a comprehensive review of current methods and clinical applications. Prog Retin Eye Res 2017;60:66– 100. Retrieved from: https://doi.org/10.1016/j.preteyeres. 2017.07.002.
12. Shahlaee A, Pefkianaki M, Hsu J, Ho AC. Measurement of foveal avascular zone dimensions and its reliability in healthy eyes using optical coherence tomography angiography. Am J Ophthalmol 2016;161:50–55e1. Retrieved from: https://doi.org/10.1016/j.ajo.2015.09.026.
13. Falavarjani KG. Optical coherence tomography angiography of the retina and choroid; current applications and future directions. J Curr Ophthalmol 2017;29:1–4.
14. Carpineto P, Mastropasqua R, Marchini G, Toto L, Di Nicola M, Di Antonio L. Reproducibility and repeatability of foveal avascular zone measurements in healthy subjects by optical coherence tomography angiography. Br J Ophthalmol 2016;100:671–676. Retrieved from: https://doi. org/10.1136/bjophthalmol-2015-307330.
15. Spaide RF, Curcio CA. Evaluation of segmentation of the superficial and deep vascular layers of the retina by optical coherence tomography angiography instruments in normal eyes. JAMA Ophthalmol 2017;135:259–262. Retrieved from: https://doi.org/10.1001/jamaophthalmol.2016.5327.
16. Rommel F, Siegfried F, Kurz M, Brinkmann MP, Rothe M, Rudolf M, et al. Impact of correct anatomical slab segmentation on foveal avascular zone measurements by optical coherence tomography angiography in healthy adults. J Curr Ophthalmol 2018;30:156–160. Retrieved from: https://doi.org/10.1016/j.joco.2018.02.001.
17. Corvi F, Pellegrini M, Erba S, Cozzi M, Staurenghi G, Giani A. Reproducibility of vessel density, fractal dimension, and foveal avascular zone using 7 different optical coherence tomography angiography devices. Am J Ophthalmol 2018;186:25–31. Retrieved from: https://doi.org/10.1016/j. ajo.2017.11.011.
18. Al-Sheikh M, Falavarjani KG, Tepelus TC, Sadda SR. Quantitative comparison of swept-source and spectraldomain OCT angiography in healthy eyes. Ophthalmic Surg Lasers Imag Retin 2017;48:385–391. Retrieved from: https://doi.org/10.3928/23258160-20170428-04.
19. Samara WA, Say EAT, Khoo CTL, Higgins TP, Magrath G, Ferenczy S, et al. Correlation of foveal avascular zone size with foveal morphology in normal eyes using optical coherence tomography angiography. Retina 2015;35:2188–2195. Retrieved from: https://doi.org/10. 1097/IAE.0000000000000847.
20. Magrath GN, Say EAT, Sioufi K, Ferenczy S, Samara WA, Shields CL. Variability in foveal avascular zone and capillary density using optical coherence tomography angiography machines in healthy eyes. Retina 2017;37:2102–2111.
21. Pilotto E, Frizziero L, Crepaldi A, Della Dora E, Deganello D, Longhin E, et al. Repeatability and reproducibility of foveal avascular zone area measurement on normal eyes by different optical coherence tomography angiography instruments. Ophthalmic Res 2018;58:4847. Retrieved from: https://doi.org/10.1159/000485463.
22. Coscas F, Sellam A, Glacet-Bernard A, Jung C, Goudot M, Miere A, et al. Normative data for vascular density in superficial and deep capillary plexuses of healthy adults assessed by optical coherence tomography angiography. Investig Ophthalmol Vis Sci 2016;57:OCT211–223. Retrieved from: https://doi.org/10.1167/iovs.15-18793.
23. Ghassemi F, Fadakar K, Bazvand F, Mirshahi R, Mohebbi M, Sabour S. The quantitative measurements of vascular density and flow areas of macula using optical coherence tomography angiography in normal volunteers. Ophthalmic Surg Lasers Imag Retin 2017;48:478–486.
24. Mihailovic N, Brand C, Lahme L, Schubert F, Bormann E, Eter N, et al. Repeatability, reproducibility and agreement of foveal avascular zone measurements using three different optical coherence tomography angiography devices. PLoS One 2018;13:e0206045. Retrieved from: https://doi.org/10.1371/journal.pone.0206045.
25. Falavarjani K, Shenazandi H, Naseri D, Anvari P, Kazemi P, Aghamohammadi F, et al. Foveal avascular zone and vessel density in healthy subjects: An optical coherence tomography angiography study. J Ophthalmic Vis Res 2018;13:260. Retrieved from: https://doi.org/10.4103/jovr. jovr_173_17.
26. Falavarjani KG, Shenazandi H, Naseri D, Anvari P, Kazemi P, Aghamohammadi F, et al. Foveal avascular zone and vessel density in healthy subjects: an optical coherence tomography angiography study. J Ophthalmic Vis Res 2018;13:260–265. Retrieved from: https://doi.org/10.4103/ jovr.jovr_173_17.