Recommendations for OCT Angiography Reporting in Retinal Vascular Disease: A Delphi Approach by International Experts.



Munk, Marion R, Kashani, Amir H, Tadayoni, Ramin, Korobelnik, Jean-Francois, Wolf, Sebastian, Pichi, Francesco, Koh, Adrian, Ishibazawa, Akihiro, Gaudric, Alain, Loewenstein, Anat
et al (show 23 more authors) (2022) Recommendations for OCT Angiography Reporting in Retinal Vascular Disease: A Delphi Approach by International Experts. Ophthalmology. Retina, 6 (9). pp. 753-761.

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Abstract

<h4>Purpose</h4>To develop a consensus nomenclature for reporting OCT angiography (OCTA) findings in retinal vascular disease (e.g., diabetic retinopathy, retinal vein occlusion) by international experts.<h4>Design</h4>Delphi-based survey.<h4>Subjects, participants, and/or controls</h4>Twenty-five retinal vascular disease and OCTA imaging experts.<h4>Methods, intervention, or testing</h4>A Delphi method of consensus development was used, comprising 2 rounds of online questionnaires, followed by a face-to-face meeting conducted virtually. Twenty-five experts in retinal vascular disease and retinal OCTA imaging were selected to constitute the OCTA Nomenclature in Delphi Study Group for retinal vascular disease. The 4 main areas of consensus were: definition of the parameters of "wide-field (WF)" OCTA, measurement of decreased vascular flow on conventional and WF-OCTA, nomenclature of OCTA findings, and OCTA in retinal vascular disease management and staging. The study end point was defined by the degree of consensus for each question: "strong consensus" was defined as ≥85% agreement, "consensus" as 80% to 84%, and "near consensus" as 70% to 79%.<h4>Main outcome measures</h4>Consensus and near consensus on OCTA nomenclature in retinal vascular disease.<h4>Results</h4>A consensus was reached that a meaningful change in percentage of flow on WF-OCTA imaging should be an increase or decrease ≥30% of the absolute imaged area of flow signal and that a "large area" of WF-OCTA reduced flow signal should also be defined as ≥30% of the absolute imaged area. The presence of new vessels and intraretinal microvascular abnormalities, the foveal avascular zone parameters, the presence and amount of "no-flow areas," and the assessment of vessel density in various retinal layers should be added for the staging and classification of diabetic retinopathy. Decreased flow ≥30% of the absolute imaged area should define an ischemic central retinal vein occlusion. Several other items did not meet consensus requirements or were rejected in the final discussion round.<h4>Conclusions</h4>This study provides international consensus recommendations for reporting OCTA findings in retinal vascular disease, which may help to improve the interpretability and description in clinic and clinical trials. Further validation in these settings is warranted and ongoing. Efforts are continuing to address unresolved questions.

Item Type: Article
Uncontrolled Keywords: Retinal Vessels, Humans, Retinal Diseases, Diabetic Retinopathy, Retinal Vein Occlusion, Tomography, Optical Coherence, Fluorescein Angiography
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences
Depositing User: Symplectic Admin
Date Deposited: 31 Jan 2023 10:38
Last Modified: 31 Jan 2023 10:38
DOI: 10.1016/j.oret.2022.02.007
Open Access URL: https://doi.org/10.1016/j.oret.2022.02.007
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3168006