Lei J, Durbin MK, Shi Y, Uji A, Balasubramanian S, Baghdasaryan E, Al-Sheikh M, Sadda SR
血管 黄斑 重复性
摘要：重要性：必须对光学相干断层扫描血管造影术（OCTA）测量的定量指标的可重复性和可重复性进行评估，才能在临床研究和实践中得到肯定的解释。目的：旨在评估OCTA源视网膜血管定量的可重复性和重现性。设计，设置和研究对象：在这个横断面研究中，共有21名健康志愿者（42只眼）和22名视网膜疾病患者（22只眼），其中14例年龄相关性黄斑变性，3例视网膜前膜，2例糖尿病视网膜病变，2例近视性黄斑变性，视网膜静脉阻塞1例。从2016年9月1日至11月31日开始招募参与者。每只眼接受3种仪器3次重复扫描，，共进行9次采集。将眼随机分配为3×3mm或6×6mm组。如果采集的信号强度小于7，则将眼排除在随后的分析之外。通过组内相关系数（ICC）和变异系数评估重复性（定义为设备内测量的一致性）和再现性（定义为相同类型设备之间的一致性）。所有眼使用3种独立的仪器进行扫描。主要预后指标：视网膜血管系统的血管长度密度（VLD）和灌注密度（PD）。结果：共对健康志愿者21名（男8例，女13例；年龄36±6岁），视网膜疾病22例（男15例，女7例；平均年龄79.9岁）进行评估。42只正常眼中有40只眼，22只视网膜疾病眼中有15只符合信号强度标准，并纳入本分析。 ICC连续3次扫描的VLD范围为0.82〜0.98，PD为0.83〜0.95。 VLD变异系数（CV）为2.2％至5.9％，PD为2.4％至5.9％。对于重现性，所有组ICC范围从0.62到0.95，CV均小于6％。内环3mm×3mm类型（ICC范围0.92 [95％CI，0.85-0.96]至0.96 [95％CI，0.93-0.98]）和外环6×6mm类型（ICC范围0.93 [95％CI，0.86-0.97]至0.96 [95％CI，0.92-0.98]）的一致性最高。结论和意义：OCTA图像可以获得浅层视网膜血管的血管长度密度和PD，具有高水平的重复性和可重复性，但可随扫描类型和位置而变化。
Importance:The repeatability and reproducibility of quantitative metrics from optical coherence tomographic angiography (OCTA) must be assessed before these data can be confidently interpreted in clinical research and practice.Objective:To evaluate the repeatability and reproducibility of OCTA-derived retinal vascular quantitative metrics.Design, Setting and Participants:In this cross-sectional study, 21 healthy volunteers (42 eyes) and 22 patients with retinal disease (22 eyes), including 14 with age-related macular degeneration, 3 with epiretinal membrane, 2 with diabetic retinopathy, 2 with myopic macular degeneration, and 1 with retinal vein occlusion, were enrolled. Participants were recruited from September 1 through November 31, 2016. Each eye underwent 3 repeated scans with 3 instruments for a total of 9 acquisitions. Eyes were randomly assigned to scanning with a 3×3-mm or 6×6-mm pattern. Eyes were excluded from subsequent analysis if any acquisition had a signal strength of less than 7. Repeatability (defined as the agreement in measurements within a device) and reproducibility (defined as the agreement between devices of the same type) were assessed by intraclass correlation coefficient (ICC) and coefficient of variation.Exposures:All eyes underwent scanning using 3 separate devices.Main Outcomes and Measures:Vessel length density (VLD) and perfusion density (PD) of the superficial retinal vasculature.Results:A total of 21 healthy volunteers (8 men and 13 women; mean [SD] age, 36  years) and 22 patients with retinal disease (15 men and 7 women; mean [SD] age, 79  years) underwent evaluation. Of these, 40 of 42 normal eyes and 15 of 22 eyes with retinal disease met signal strength criteria and were included in this analysis. The ICC among the 3 consecutive scans ranged from 0.82 to 0.98 for VLD and from 0.83 to 0.95 for PD. The coefficient of variation (CV) ranged from 2.2% to 5.9% for VLD and from 2.4% to 5.9% for PD. For reproducibility, the ICC ranged from 0.62 to 0.95 and the CV was less than 6% in all groups. The agreement was highest for the 3×3-mm pattern in the inner ring (ICC range, 0.92 [95% CI, 0.85-0.96] to 0.96 [95% CI, 0.93-0.98]) and 6×6-mm pattern in the outer ring (ICC range, 0.93 [95% CI, 0.86-0.97] to 0.96 [95% CI, 0.92-0.98]).Conclusions and Relevance:Vessel length density and PD of the superficial retinal vasculature can be obtained from OCTA images with high levels of repeatability and reproducibility but can vary with scan pattern and location.