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

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机构: [1]Univ Bern, Bern Univ Hosp, Dept Ophthalmol, Inselspital, Bern, Switzerland [2]Univ Bern, Bern Univ Hosp, Bern Photog Reading Ctr, Inselspital, Bern, Switzerland [3]Johns Hopkins Univ Hosp, Wilmer Eye Inst, Baltimore, MD 21287 USA [4]Hop Fdn Rothschild, Hop Lariboisiere, AP HP, Ophthalmol Dept, Paris, France [5]Univ Paris, Paris, France [6]CHU Bordeaux, Serv Ophtalmol, Bordeaux, France [7]Univ Bordeaux, BPH, INSERM, U1219, F-33000 Bordeaux, France [8]Cleveland Clin Abu Dhabi, Eye Inst, Abu Dhabi, U Arab Emirates [9]Case Western Reserve Univ, Cleveland Clin, Lerner Coll Med, Cleveland, OH 44106 USA [10]Camden Med, Eye & Retina Surg, Singapore, Singapore [11]Asahikawa Med Univ, Dept Ophthalmol, Asahikawa, Hokkaido, Japan [12]Univ Paris, Ophthalmol Dept, Hop Lariboisiere, AP HP, 2 Rue Ambroise Pare, F-75010 Paris, France [13]Tel Aviv Med Ctr & Sch Med, Sackler Fac Med, Dept Ophthalmol, Tel Aviv, Israel [14]Ctr Italiano Macula, Rome, Italy [15]Tufts Univ, Sch Med, Tufts Med Ctr, New England Eye Ctr, Boston, MA 02111 USA [16]Univ Calif Los Angeles, David Geffen Sch Med, Stein Eye Inst, Dept Ophthalmol, Los Angeles, CA 90095 USA [17]Univ Toronto, Dept Ophthalmol, Unity Hlth Toronto, Toronto, ON, Canada [18]Univ Chicago, Dept Ophthalmol & Visual Sci, Chicago, IL 60637 USA [19]Univ Rosario, Fdn Oftalmol Nacl, Bogota, DC, Colombia [20]Univ Milan, Dept Biomed & Clin Sci Luigi Sacco, Luigi Sacco Hosp, Milan, Italy [21]Royal Liverpool Univ Hosp, St Pauls Eye Unit, Liverpool, Merseyside, England [22]Med Coll Wisconsin, Dept Ophthalmol, Milwaukee, WI 53226 USA [23]Vitreous Retina Macula Consultants New York, New York, NY USA [24]NYU, Dept Ophthalmol, Grossman Sch Med, 550 1St Ave, New York, NY 10016 USA [25]Sci Inst San Raffaele Hosp, Dept Ophthalmol, Milan, Italy [26]Tufts Univ, Sch Med, Dept Ophthalmol, Boston, MA 02111 USA [27]New York Eye & Ear Infirm Mt Sinai, Dept Ophthalmol, New York, NY USA [28]Vitreous Retina Macula Consultants New York, Dept Ophthalmol, New York, NY USA [29]Natl Hosp Org, Kyushu Med Ctr, Dept Ophthalmol, Fukuoka, Japan [30]Doheny Eye Inst, Doheny Image Reading Ctr, 1355 San Pablo St, Los Angeles, CA 90033 USA [31]Univ Milan, Dept Biomed Surg & Dent Sci, Milan, Italy [32]Eye Clin IRCCS MultiMed, Milan, Italy [33]Natl Univ Singapore, Singapore Eye Res Inst, Duke NUS Med Sch, Dept Ophthalmol,Singapore Natl Eye Ctr, Singapore, Singapore [34]Shinshu Univ, Dept Ophthalmol, Sch Med, 3-1-1 Asahi, Matsumoto, Nagano 3908621, Japan [35]Queens Univ, Ophthalmol & Vis Sci, Belfast, Antrim, North Ireland [36]Nagoya City Univ, Grad Sch Med Sci, Dept Ophthalmol & Visual Sci, Nagoya, Aichi, Japan [37]Karl Landsteiner Inst Clin Risk Management, Vienna, Austria [38]Capital Med Univ, Beijing Tongren Hosp, Beijing Tongren Eye Ctr, Beijing, Peoples R China
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关键词: Nomenclature Retinal vascular diseases OCT angiography Delphi Consensus approach diabetic retinopathy retinal vein occlusion

摘要:
Purpose: 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. Subjects, Participants, and/or Controls: Twenty-five retinal vascular disease and OCTA imaging experts. Methods, Intervention, or Testing: 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%. Main Outcome Measures: Consensus and near consensus on OCTA nomenclature in retinal vascular disease. Results: 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 WFOCTA 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. Conclusions: 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. Ophthalmology Retina 2022;6:753-761 (c) 2022 by the American Academy of Ophthalmology. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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Q1 OPHTHALMOLOGY

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第一作者机构: [1]Univ Bern, Bern Univ Hosp, Dept Ophthalmol, Inselspital, Bern, Switzerland [2]Univ Bern, Bern Univ Hosp, Bern Photog Reading Ctr, Inselspital, Bern, Switzerland [*1]Inselspital Bern, Freiburgerstr 4, CH-3010 Bern, Switzerland
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通讯机构: [1]Univ Bern, Bern Univ Hosp, Dept Ophthalmol, Inselspital, Bern, Switzerland [2]Univ Bern, Bern Univ Hosp, Bern Photog Reading Ctr, Inselspital, Bern, Switzerland [*1]Inselspital Bern, Freiburgerstr 4, CH-3010 Bern, Switzerland
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