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Anvari P, Ashrafkhorasani M, Habibi A, Ghasemi Falavarjani K. Artifacts in Optical Coherence Tomography Angiography. JOVR [Internet]. 2021Apr.29 [cited 2024Jul.18];16(2):271–286. Available from: https://knepublishing.com/index.php/JOVR/article/view/9091
https://doi.org/10.18502/jovr.v16i2.9091
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- Cited by 12 articles
authors
-
Pasha Anvari
Pasha Anvari
Eye Research Center, The Five Senses Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
-
Maryam Ashrafkhorasani
Maryam Ashrafkhorasani
Eye Research Center, The Five Senses Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
-
Abbas Habibi
Abbas Habibi
Eye Research Center, The Five Senses Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
-
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
- Apr 29, 2021
Artifacts in Optical Coherence Tomography Angiography
Abstract
We performed a comprehensive search of the published literature in PubMed and Google Scholar to identify types, prevalence, etiology, clinical impact, and current methods for correction of various artifacts in optical coherence tomography angiography (OCTA) images. We found that the prevalence of OCTA image artifacts is fairly high. Artifacts associated with eye motion, misidentification of retinal layers, projections, and low optical coherence tomography signal are the most prevalent types. Artifacts in OCTA images are the major limitations of this diagnostic modality in clinical practice and identification of these artifacts and measures to mitigate them are essential for correct diagnosis and follow-up of patients.
Keywords:
Artifact, Artefact, Capillary Plexus, Image Quality, Optical Coherence Tomography Angiography, Projection, Segmentation, Vessel Density
References
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10. Hsu ST, Vajzovic L. Handbook of pediatric retinal OCT and the eye–brain connection. Elsevier; 2020. Chapter 8, Identifying artifacts in OCT angiography; 45–54.
11. Tomlinson A, Hasan B, Lujan BJ. Importance of focus in OCT angiography. Ophthalmol Retin [Internet] 2018;2:748–749.
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48. Bernucci MT, Merkle CW, Srinivasan VJ. Investigation of artifacts in retinal and choroidal OCT angiography with a contrast agent. Biomed Opt Express [Internet] 2018;9:1020.
49. Ghasemi Falavarjani K, Al-Sheikh M, Darvizeh F, Sadun AA, Sadda SR. Retinal vessel calibre measurements by optical coherence tomography angiography. Br J Ophthalmol 2017;101:989–992.
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52. Bazvand F, Ghassemi F. Artifacts in macular optical coherence tomography. J Curr Ophthalmol 2020;32:123.
53. Pichi F, Smith SD, Abboud EB, Neri P, Woodstock E, Hay S, et al. Wide-field optical coherence tomography angiography for the detection of proliferative diabetic retinopathy. Graefes Arch Clin Exp Ophthalmol 2020;258:1901–1909.
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2. Spaide RF, Klancnik JM, Cooney MJ. Retinal vascular layers imaged by fluorescein angiography and optical coherence tomography angiography. JAMA Ophthalmol [Internet] 2015;133:45.
3. Pellegrini M, Cozzi M, Staurenghi G, Corvi F. Comparison of wide field optical coherence tomography angiography with extended field imaging and fluorescein angiography in retinal vascular disorders. PLoS ONE [Internet] 2019;14:e0214892.
4. Fang PP, Lindner M, Steinberg JS, Müller PL, Gliem M, Charbel Issa P, et al. [Clinical applications of OCT angiography]. Ophthalmologe [Internet] 2016;113:14–22.
5. Naseripour M, Ghasemi Falavarjani K, Mirshahi R, Sedaghat A. Optical coherence tomography angiography (OCTA) applications in ocular oncology. Eye [Internet] 2020;34:1535–1545.
6. Akil H, Falavarjani KG, Sadda SR, Sadun AA. Optical coherence tomography angiography of the optic disc; an overview. J Ophthalmic Vis Res [Internet] 107;12:98–105.
7. Tan ACS, Tan GS, Denniston AK, Keane PA, Ang M, Milea D, et al. An overview of the clinical applications of optical coherence tomography angiography. Eye [Internet] 2018;32:262–286.
8. de Carlo TE, Romano A, Waheed NK, Duker JS. A review of optical coherence tomography angiography (OCTA). Int J Retin Vitr [Internet] 2015;1:5.
9. Spaide RF, Fujimoto JG, Waheed NK. Image artifacts in optical coherence tomography angiography. Retina [Internet] 2015 [cited 2017 Jul 13];35:2163–2180.
10. Hsu ST, Vajzovic L. Handbook of pediatric retinal OCT and the eye–brain connection. Elsevier; 2020. Chapter 8, Identifying artifacts in OCT angiography; 45–54.
11. Tomlinson A, Hasan B, Lujan BJ. Importance of focus in OCT angiography. Ophthalmol Retin [Internet] 2018;2:748–749.
12. Govindaswamy N, Gadde SG, Chidambara L, Bhanushali D, Anegondi N, Sinha Roy A. Quantitative evaluation of optical coherence tomography angiography images of diabetic retinopathy eyes before and after removal of projection artifacts. J Biophotonics [Internet] 2018;11:e201800003.
13. Ghasemi Falavarjani K, Al-Sheikh M, Akil H, Sadda SR. Image artefacts in swept-source optical coherence tomography angiography. Br J Ophthalmol [Internet] 2017 [cited 2017 Jul 13];101:564–568.
14. Stepien KE, Konda SM, Etheridge T, Holmen I, Kopplin L, Pak JW, et al. Impact of artifacts in optical coherence tomography angiography image analysis. Invest Ophthalmol Vis Sci 2020;61:4818.
15. Holmen IC, Konda SM, Pak JW, McDaniel KW, Blodi B, Stepien KE, et al. Prevalence and severity of artifacts in optical coherence tomographic angiograms. JAMA Ophthalmol 2020;138:119–126.
16. Iftikhar M, Zafar S, Gonzalez N, Murphy O, Ohemaa Kwakyi MS, Sydney Feldman BS, et al. Image artifacts in optical coherence tomography angiography among patients with multiple sclerosis. Curr Eye Res 2019;44:558–563.
17. Weijing C, Zhang X, Wang W. Artifacts associated with swept-source OCT-angiography measurements in glaucoma. Invest Ophthalmol Vis Sci 2020;61:4117.
18. Chen JJ, Kardon RH. Avoiding clinical misinterpretation and artifacts of optical coherence tomography analysis of the optic nerve, retinal nerve fiber layer, and ganglion cell layer. J Neuroophthalmol 2016;36:417.
19. Chen FK, Viljoen RD, Bukowska DM. Classification of image artefacts in optical coherence tomography angiography of the choroid in macular diseases. Clin Experiment Ophthalmol 2016;44:388–399.
20. Say EAT, Ferenczy S, Magrath GN, Samara WA, Khoo CTL, Shields CL. Image quality and artifacts on optical coherence tomography angiography: comparison of pathologic and paired fellow eyes in 65 patients with unilateral choroidal melanoma treated with plaque radiotherapy. Retina [Internet] 2017;37:1660–1673.
21. Enders C, Lang GKGE, Dreyhaupt J, Loidl M, Lang GKGE, Werner JU. Quantity and quality of image artifacts in optical coherence tomography angiography. PLoS ONE 2019;14:e0210505.
22. Ghasemi Falavarjani K, Habibi A, Anvari P, Ghasemizadeh S, Ashraf Khorasani M, Shenazandi H, et al. Effect of segmentation error correction on optical coherence tomography angiography measurements in healthy subjects and diabetic macular oedema. Br J Ophthalmol [Internet] 2020;104:162–166.
23. Al-Sheikh M, Ghasemi Falavarjani K, Akil H, Sadda SR. Impact of image quality on OCT angiography based quantitative measurements. Int J Retin Vitr [Internet] 2017;3:13.
24. Li X-X, Wu W, Zhou H, Deng J-J, Zhao M-Y, Qian T-W, et al. A quantitative comparison of five optical coherence tomography angiography systems in clinical performance. Int J Ophthalmol [Internet] 2018;11:1784–1795.
25. Reich M, Boehringer D, Rothaus K, Cakir B, Bucher F, Daniel M, et al. Swept-source optical coherence tomography angiography alleviates shadowing artifacts caused by subretinal fluid. Int Ophthalmol [Internet]. 2020;40:2007–2016.
26. Moghimi S, Zangwill LM, Penteado RC, Hasenstab K, Ghahari E, Hou H, et al. Macular and optic nerve head vessel density and progressive retinal nerve fiber layer loss in glaucoma. Ophthalmology [Internet] 2018;125:1720–1728.
27. Rao HL, Pradhan ZS, Weinreb RN, Riyazuddin M, Dasari S, Venugopal JP, et al. Vessel density and structural measurements of optical coherence tomography in primary angle closure and primary angle closure glaucoma. Am J Ophthalmol [Internet] 2017;177:106–115.
28. Lauermann JL, Woetzel AK, Treder M, Alnawaiseh M, Clemens CR, Eter N, et al. Prevalences of segmentation errors and motion artifacts in OCT-angiography differ among retinal diseases. Graefe’s Arch Clin Exp Ophthalmol 2018;256:1807–1816.
29. Lauermann JL, Treder M, Heiduschka P, Clemens CR, Eter N, Alten F. Impact of eye-tracking technology on OCT-angiography imaging quality in age-related macular degeneration. Graefe’s Arch Clin Exp Ophthalmol 2017;255:1535–1542.
30. Ho J, Dans K, You Q, Nudleman ED, Freeman WR. Comparison of 3 mm × 3 mm versus 6 mm × 6 mm optical coherence tomography angiography scan sizes in the evaluation of non-proliferative diabetic retinopathy. Retina [Internet] 2019;39:259–264.
31. Zhang A, Zhang Q, Wang RK. Minimizing projection artifacts for accurate presentation of choroidal neovascularization in OCT micro-angiography. Biomed Opt Express [Internet] 2015;6:4130–4143.
32. Louzada RN, de Carlo TE, Adhi M, Novais EA, Durbin MK, Cole E, et al. Optical coherence tomography angiography artifacts in retinal pigment epithelial detachment. Can J Ophthalmol [Internet] 2017;52:419–424.
33. Chen L, Zhang X, Gan Y, Liu B, Zhang Y, Wen F. Retinal pigment epithelium hyperplasia overlying pigment epithelial detachment in age-related macular degeneration can masquerade as neovascularization on optical coherence tomography angiography. Graefe’s Arch Clin Exp Ophthalmol 2018;256:2283–2291.
34. Maruko I, Spaide RF, Koizumi H, Sawaguchi S, Izumi T, Hasegawa T, et al. Choroidal blood flow visualization in high myopia using a projection artifact method in optical coherence tomography angiography. Retina [Internet] 2017;37:460–465.
35. Zhang M, Hwang TS, Campbell JP, Bailey ST, Wilson DJ, Huang D, et al. Projection-resolved optical coherence tomographic angiography. Biomed Opt Express [Internet] 2016;7:816–828.
36. De Pretto LR, Moult EM, Alibhai AY, Carrasco-Zevallos OM, Chen S, Lee B, et al. Controlling for artifacts in widefield optical coherence tomography angiography measurements of non-perfusion area. Sci Rep [Internet] 2019;9:9096.
37. Spaide RF, Fujimoto JG, Waheed NK, Sadda SR, Staurenghi G. Optical coherence tomography angiography. Prog Retin Eye Res [Internet] 2018;64:1–55.
38. Corvi F, Cozzi M, Invernizzi A, Pace L, Sadda SR, Staurenghi G. Optical coherence tomography angiography for detection of macular neovascularization associated with atrophy in age-related macular degeneration. Graefe’s Arch Clin Exp Ophthalmol [Internet] 2020;259:291–299.
39. Nesper PL, Lutty GA, Fawzi AA. Residual choroidal vessels in atrophy can masquerade as choroidal neovascularization on optical coherence tomography angiography: introducing a clinical and software approach. Retina [Internet] 2018;38:1289–1300.
40. Cui Y, Zhu Y, Wang JC, Lu Y, Zeng R, Katz R, et al. Imaging artifacts and segmentation errors with wide-field swept-source optical coherence tomography angiography in diabetic retinopathy. Transl Vis Sci Technol [Internet] 2019;8:18.
41. Borrelli E, Viggiano P, Evangelista F, Toto L, Mastropasqua R. Eyelashes artifact in ultra-widefield optical coherence tomography angiography. Ophthalmic Surg Lasers Imaging Retin 2019;50:740–743.
42. Falavarjani KG, Khadamy J, Safi H, Karimi N, Amirkourjani F. Effect of grid decentration on macular thickness measurements in normal subjects and patients with diabetic macular edema. Eur J Ophthalmol [Internet] 25:218–221.
43. Kashani AH, Green KM, Kwon J, Chu Z, Zhang Q, Wang RK, et al. Suspended scattering particles in motion: a novel feature of OCT angiography in exudative maculopathies. Ophthalmol Retin 2018;2:694–702.
44. Maltsev DS, Kulikov AN, Kazak AA, Freund KB. Suspended scattering particles in motion may influence optical coherence tomography angiography vessel density metrics in eyes with diabetic macular edema. Retina 2020; online ahead of print.
45. Fragiotta S, Fernández-Avellaneda P, Breazzano MP, Yannuzzi LA, Curcio CA, Freund KB. Linear and planar reflection artifacts on swept-source and spectral-domain optical coherence tomography due to hyperreflective crystalline deposits. Graefe’s Arch Clin Exp Ophthalmol [Internet]. 2020;258:491–501.
46. Hua R, Wang H. Dark signals in the choroidal vasculature on optical coherence tomography angiography: an artefact or not? J Ophthalmol 2017;2017:5498125.
47. Maruko I, Kawano T, Arakawa H, Hasegawa T, Iida T. Visualizing large choroidal blood flow by subtraction of the choriocapillaris projection artifacts in swept source optical coherence tomography angiography in normal eyes. Sci Rep 2018;8:1–8.
48. Bernucci MT, Merkle CW, Srinivasan VJ. Investigation of artifacts in retinal and choroidal OCT angiography with a contrast agent. Biomed Opt Express [Internet] 2018;9:1020.
49. Ghasemi Falavarjani K, Al-Sheikh M, Darvizeh F, Sadun AA, Sadda SR. Retinal vessel calibre measurements by optical coherence tomography angiography. Br J Ophthalmol 2017;101:989–992.
50. Munk MR, Giannakaki-Zimmermann H, Berger L, Huf W, Ebneter A, Wolf S, et al. OCT-angiography: a qualitative and quantitative comparison of 4 OCT-A devices. PLoS ONE 2017;12:e0177059.
51. Ang M, Tan ACS, Cheung CMG, Keane PA, Dolz-Marco R, Sng CCA, et al. Optical coherence tomography angiography: a review of current and future clinical applications. Graefe’s Arch Clin Exp Ophthalmol 2018;256:237–245.
52. Bazvand F, Ghassemi F. Artifacts in macular optical coherence tomography. J Curr Ophthalmol 2020;32:123.
53. Pichi F, Smith SD, Abboud EB, Neri P, Woodstock E, Hay S, et al. Wide-field optical coherence tomography angiography for the detection of proliferative diabetic retinopathy. Graefes Arch Clin Exp Ophthalmol 2020;258:1901–1909.
54. Camino A, Zhang M, Gao SS, Hwang TS, Sharma U, Wilson DJ, et al. Evaluation of artifact reduction in optical coherence tomography angiography with real-time tracking and motion correction technology. Biomed Opt Express 2016;7:3905–3915.
55. Sharma U, Everett MJ. Data acquisition methods for reduced motion artifacts and applications in OCT angiography. Google Patents [Internet] 2014.
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