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Research output: Contribution to Journal/Magazine › Journal article › peer-review
Research output: Contribution to Journal/Magazine › Journal article › peer-review
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TY - JOUR
T1 - Imaging of corneal neovascularization
T2 - Optical coherence tomography angiography and fluorescence angiography
AU - Brunner, Matthias
AU - Romano, Vito
AU - Steger, Bernhard
AU - Vinciguerra, Riccardo
AU - Lawman, Samuel
AU - Williams, Bryan
AU - Hicks, Nicholas
AU - Czanner, Gabriela
AU - Zheng, Yalin
AU - Willoughby, Colin E.
AU - Kaye, Stephen B.
PY - 2018/3/1
Y1 - 2018/3/1
N2 - PURPOSE. The purpose of this study was to compare optical coherence tomography angiography (OCTA) and indocyanine green angiography (ICGA) for the assessment of corneal neovascularization (CoNV). METHODS. Patients with CoNV extending at least 3 mm into the cornea were included. All patients underwent corneal imaging at the same visit. Images were recorded using the AngioVue OCTA system (Optovue, Inc.) with the long corneal adaptor module (CAM-L). ICGA images were recorded with fluorescent filters using the Heidelberg system (HRA2 Scanning Laser Ophthalmoscope; Heidelberg Engineering). Images were graded for quality by two independent observers. Vessel parameters: area, number, diameter, branch and end points, and tortuosity, were compared between devices. Bland-Altman plots were used to assess differences between parameters. RESULTS. Fifteen patients with CoNV predominantly associated with microbial keratitis were included. Mean subjective image quality score was better for ICGA (3.3 ± 0.9) than for OCTA (2.1 ± 1.2, P = 0.002), with almost perfect interobserver agreement for ICGA images (κ = 0.83) and substantial agreement for OCTA images (κ = 0.69). Agreement of grading of all investigated vessel parameters between ICGA and OCT images was slight to moderate, with significant differences found for vessel diameter (8.98 μm, P = 0.01, 95% limits of agreement [LOA]: 15.89 to 2.07), number of branch (25.93, P = 0.09, 95% LOA: 4.31 to 56.17), and terminal points (49, P = 0.05, 95% LOA: 0.78 to 97.22). CONCLUSION. Compared with ICGA, current OCTA systems are less precise in capturing small vessels in CoNV complexes, and validation studies are needed for OCTA segmentation software. OCTA, however, complements ICGA by providing evidence of red blood cell flow, which together with depth information, may be helpful when planning treatment of CoNV.
AB - PURPOSE. The purpose of this study was to compare optical coherence tomography angiography (OCTA) and indocyanine green angiography (ICGA) for the assessment of corneal neovascularization (CoNV). METHODS. Patients with CoNV extending at least 3 mm into the cornea were included. All patients underwent corneal imaging at the same visit. Images were recorded using the AngioVue OCTA system (Optovue, Inc.) with the long corneal adaptor module (CAM-L). ICGA images were recorded with fluorescent filters using the Heidelberg system (HRA2 Scanning Laser Ophthalmoscope; Heidelberg Engineering). Images were graded for quality by two independent observers. Vessel parameters: area, number, diameter, branch and end points, and tortuosity, were compared between devices. Bland-Altman plots were used to assess differences between parameters. RESULTS. Fifteen patients with CoNV predominantly associated with microbial keratitis were included. Mean subjective image quality score was better for ICGA (3.3 ± 0.9) than for OCTA (2.1 ± 1.2, P = 0.002), with almost perfect interobserver agreement for ICGA images (κ = 0.83) and substantial agreement for OCTA images (κ = 0.69). Agreement of grading of all investigated vessel parameters between ICGA and OCT images was slight to moderate, with significant differences found for vessel diameter (8.98 μm, P = 0.01, 95% limits of agreement [LOA]: 15.89 to 2.07), number of branch (25.93, P = 0.09, 95% LOA: 4.31 to 56.17), and terminal points (49, P = 0.05, 95% LOA: 0.78 to 97.22). CONCLUSION. Compared with ICGA, current OCTA systems are less precise in capturing small vessels in CoNV complexes, and validation studies are needed for OCTA segmentation software. OCTA, however, complements ICGA by providing evidence of red blood cell flow, which together with depth information, may be helpful when planning treatment of CoNV.
KW - Cornea neovascularization
KW - Corneal imaging
KW - Fluorescence angiography
KW - Indocyanine green angiography
KW - Optical coherence tomography angiography
U2 - 10.1167/iovs.17-22035
DO - 10.1167/iovs.17-22035
M3 - Journal article
C2 - 29625447
AN - SCOPUS:85043386917
VL - 59
SP - 1263
EP - 1269
JO - Investigative Ophthalmology and Visual Science
JF - Investigative Ophthalmology and Visual Science
SN - 0146-0404
IS - 3
ER -