研究目的
To evaluate the reproducibility of vessel density calculations using different binarization methods obtained via two commercially available swept-source optical coherence tomography angiography (SS-OCTA) systems.
研究成果
Both SS-OCTA instruments demonstrated good reproducibility for macular vessel density measurements, with PLEXElite showing fewer poor-quality images and higher reproducibility than Triton. Local adaptive thresholding methods provided better reproducibility than global methods. These findings support the careful selection of binarization methods and devices in clinical practice for assessing vascular diseases of the central retina, and highlight the need for cautious comparisons across different methodologies.
研究不足
Enrolled subjects were relatively young with a narrow age range, potentially limiting generalizability. Many eyes (36.7%) were excluded due to poor image quality, introducing possible selection bias. The binarization methods selected were based on literature and may not cover all algorithms; noise was not fully excluded, and some could be misinterpreted as vascular signals. The study did not investigate reasons for discrepancies between devices, such as different algorithms or pixel sizes.
1:Experimental Design and Method Selection:
This prospective cross-sectional study involved imaging healthy volunteers using two SS-OCTA devices (PLEXElite and Triton) with a 3x3-mm volume scan pattern centered on the fovea. Six binarization methods (two global and four local adaptive thresholding) were applied using ImageJ software to calculate vessel density. Reproducibility was assessed through intraobserver coefficients of correlation (ICC) and coefficients of variation (CV).
2:Sample Selection and Data Sources:
Healthy subjects aged 20 years or older were recruited from an ophthalmology outpatient clinic. Exclusion criteria included various ocular diseases, poor image quality, and specific refractive errors. A total of 60 eyes from 30 subjects were initially included, with 38 eyes from 23 subjects ultimately analyzed after exclusions.
3:List of Experimental Equipment and Materials:
SS-OCTA devices: PLEXElite (PLEX Elite 9000, Carl Zeiss Meditec) and Triton (Topcon DRI OCT Triton); ImageJ software (National Institutes of Health); other ophthalmic equipment for comprehensive exams (e.g., slit-lamp biomicroscopy, noncontact tonometry, fundus photography).
4:Experimental Procedures and Operational Workflow:
Subjects underwent imaging with both SS-OCTA devices twice a day. Images were binarized using the six methods in ImageJ without noise removal. Two blinded reviewers assessed image quality, excluding poor-quality scans. Vessel density was calculated as the proportion of angiography signal in the 3x3-mm macula area.
5:Data Analysis Methods:
Statistical analyses included calculation of ICC and CV for reproducibility, paired t-tests to compare vessel densities between instruments, and use of JMP, Stata, and SPSS software for analysis. A P-value less than 0.05 was considered significant.
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PLEX Elite 9000
Version 1.6.0.21130
Carl Zeiss Meditec
Swept-source optical coherence tomography angiography system used for imaging the retinal microvasculature, specifically for macular vessel density calculations.
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Humphrey Field Analyzer
HFA
Carl Zeiss Meditec
Automated visual field analyzer used for measuring visual fields in the comprehensive ophthalmic examination.
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Topcon DRI OCT Triton
Topcon
Swept-source optical coherence tomography angiography system used for imaging the retinal microvasculature, specifically for macular vessel density calculations.
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ImageJ
National Institutes of Health
Software used for binarization of OCTA images to calculate vessel density, employing various thresholding methods.
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Tonoref II
Nidek Co., Ltd.
Noncontact tonometer used for measuring intraocular pressure in the comprehensive ophthalmic examination.
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CX-1
Canon Inc.
Fundus camera used for fundus photography in the comprehensive ophthalmic examination.
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Optical Biometer OA-2000
Tomey Corp.
Device used for measuring axial length and central corneal thickness in the comprehensive ophthalmic examination.
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Spectralis HRA 2
Heidelberg Engineering
Device used for measuring retinal nerve fiber layer thickness in the comprehensive ophthalmic examination.
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JMP
version 10.1
SAS Institute Inc.
Statistical software used for data analysis in the study.
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Stata
version 14
StataCorp LP
Statistical software used for data analysis in the study.
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SPSS
version 25
SPSS
Statistical software used for data analysis in the study.
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