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Repeatability and reproducibility of quantitative OCT angiography measurements from table-top and portable Flex Spectralis devices

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Abstract

Purpose

The recent development of a portable investigational handheld OCT-angiography (OCTA) device has allowed for expansion of imaging into the operating room (OR) in addition to standard in-clinic imaging. The aim of this study was to assess intravisit repeatability and intervisit reproducibility of retinal microvasculature measures and central retinal thickness for in-clinic table-top and portable OR compatible OCTA devices.

Methods

Repeated 10 × 10 OCTA images were acquired in 20 healthy adult participants on two separate visit days using Spectralis spectral-domain OCTA table-top and investigational armature suspended Flex systems. Intravisit and intervisit intraclass correlation coefficients and average absolute percent difference were calculated for quantitative microvasculature measures and CRT.

Results

120 OCTA images were acquired from 20 subjects (n = 20, mean age 26.7 ± 1.61 years, range 24–30 years) with both devices across two separate imaging days. FAZ and CRT measurements had near complete intravisit and intervisit agreement with ICCs between .97 and 1 for both table-top (FAZ ICC .97, .97; CRT ICC .98–1, .98–.99) and Flex (FAZ ICC .97, .95; CRT ICC .99–1, .98–.99) devices. Vessel density measures demonstrated greater variance with only fair to strong agreement (ICC .32–.75) and average absolute percent differences ranging from 2.96 to 6.63%.

Conclusion

FAZ and CRT measures for both devices demonstrated high repeatability and reproducibility; retinal vessel density measures demonstrated less. Differences of less than 7% for retinal microvasculature measurements across time and devices are most likely attributable to expectable variance between repeat scans.

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Acknowledgements

LV Heidelberg Engineering Research and Equipment Grant (Heidelberg Engineering, Heidelberg, Germany).

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All named authors have contributed to this paper in accordance with the ICMJE guidelines.

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Correspondence to Arathi Ponugoti.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the Duke University Health System Institutional Review Board and adhered to the Health Insurance Portability and Accountability Act and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Author LV has received a research and equipment grant from Heidelberg Engineering (Heidelberg Engineering, Heidelberg, Germany). AP, NG, SS, and MK have no conflicts of interest and as such certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements) or non-financial interest (such as personal or professional relationships, affiliations, knowledge, or beliefs) in the subject matter or materials discussed in this manuscript.

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Ponugoti, A., Ngo, H., Stinnett, S. et al. Repeatability and reproducibility of quantitative OCT angiography measurements from table-top and portable Flex Spectralis devices. Graefes Arch Clin Exp Ophthalmol 262, 1785–1793 (2024). https://doi.org/10.1007/s00417-023-06351-3

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