Work

The Artifacts in Macular and Peripapillary OCT Angiography in Patients with Different Severities of Glaucoma

Year: 2025

Type: article

Abstract: Purpose To investigate the prevalence and types of artifacts in optical coherence tomography angiography (OCTA) among patients with different glaucoma severities Design Prospective, cross-sectional study Subjects Patients with open-angle glaucoma from a tertiary center were prospectively categorized into mild (mean deviation [MD] of 24-2 visual field ≥ -6 dB), moderate (-6 > MD ≥ -12 dB), advanced (-12 > MD ≥ -20 dB), and severe glaucoma group (MD < –20 dB). Methods AngioVue OCTA was performed three times within a single visit to obtain superficial and deep macular vessel density (VD) with 3x3-mm macular scans, and peripapillary VD with 4.5x4.5-mm scans centered on the optic disc. The intrasession variability was assessed by the coefficient of variation (CoV). Different types of image artifacts were identified. Main Outcome Measures The prevalence of artifacts in patients with varying glaucoma severities, patient-related factors associated with artifact occurrence, and their impact on scan quality index (SQI) and variability of OCTA parameters. Results Among 57 mild, 46 moderate, 46 advanced, and 39 severe glaucoma eyes, half of OCTA images exhibited artifacts. Their prevalence increased from 30% in mild to 67% in severe glaucoma (P < 0.001) for peripapillary scans and from 39% to 62% (P = 0.001) for macular scans. Defocus was the most common artifact (26%) and increased with worsening MD (P = 0.006), contributing to greater CoV of superficial (P = 0.043) and deep (P = 0.024) macular VD and reduced macular SQI (P = 0.018). Peripapillary scans were more affected by artifacts, with defocus (P < 0.001) and eye movement (P = 0.025) increasing as MD worsened, which reduced the peripapillary SQI (P = 0.003 and P < 0.001, respectively). Lower SQI (P < 0.001), eye movement (P = 0.042), and quilt (P = 0.047) were linked to greater CoV of peripapillary VD. Conclusions Defocus is the most common OCTA artifact in glaucoma patients, increasing variability in OCTA metrics. Its prevalence rises with glaucoma severity and remains high even in scans with acceptable image quality, emphasizing the need for careful artifact assessment.

Source: Ophthalmology Science

DOI: 10.1016/j.xops.2025.100964

Authors: Yun Hsia, Hsiao-Lien Chang, Tsing-Hong Wang, Jehn-Yu Huang, Chien-Chia Su

Institutions: National Taiwan University, National Taiwan University Hospital

Language: English

Topic: Glaucoma and retinal disorders

Subfield: Ophthalmology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,500