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Optical coherence tomography angiography and indocyanine green angiography for corneal vascularisation
  1. Marcus Ang1,2,
  2. Yijun Cai2,
  3. Becky MacPhee2,
  4. Dawn A Sim2,3,
  5. Pearse A Keane2,3,
  6. Chelvin C A Sng1,2,4,
  7. Catherine A Egan2,3,
  8. Adnan Tufail2,3,
  9. Daniel F Larkin2,3,
  10. Mark R Wilkins2,3
  1. 1Singapore National Eye Center, Singapore Eye Research Institute, Singapore, Singapore
  2. 2Moorfields Eye Hospital NHS Foundation Trust, London, UK
  3. 3Institute of Ophthalmology, University College London, London, UK
  4. 4Department of Ophthalmology, National University Hospital, Singapore, Singapore
  1. Correspondence to Dr Marcus Ang, Singapore National Eye Centre, Singapore Eye Research Institute, 11 Third Hospital Avenue, Singapore 168751, Singapore; marcus.ang{at}


Background/Aim To describe an optical coherence tomography angiography (OCTA) system adapted for anterior segment imaging, compared with indocyanine green angiography (ICGA) in eyes with corneal vascularisation.

Methods Retrospective study of subjects with corneal vascularisation secondary to microbial keratitis who had OCTA scans performed using a commercially available split-spectrum amplitude-decorrelation algorithm angiography system (AngioVue; Optovue Inc., Fremont, California, USA) and ICGA images (Spectralis; Heidelberg Engineering, Heidelberg, Germany). The agreement between OCTA and ICGA techniques in terms of area of vascularisation measured, using Bland–Altman 95% limits of agreement (LOA).

Results We compared the area of corneal vascularisation in 64 scan images (eight eyes, four scans for each angiography technique). In our series, the overall mean area of vascularisation from the ICGA scans was 0.49±0.34 mm2 and OCTA scans was 0.51±0.36 mm2. We obtained substantial repeatability in terms of image quality score (κ=0.80) for all OCTA scans. The agreement between OCTA and ICGA scans was good, although ICGA measured a smaller area compared with the OCTA with a mean difference of −0.03 mm2 (95% CI −0.07 to 0.01). The LOA ranged from a lower limit of −0.27 (95% CI −0.34 to −0.19) to an upper limit of 0.20 (95% CI 0.13 to 0.28, p=0.127).

Conclusions We found that rapid, non-contact OCTA adapted for the cornea was comparable with ICGA for measurement of the area of corneal vascularisation in this pilot clinical study. Further prospective studies are required to confirm if this relatively new imaging technique may be further developed to replace invasive angiography techniques for the anterior segment.

  • Cornea
  • Imaging
  • Neovascularisation

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  • Twitter Follow Mark Wilkins at @wilkoman

  • Funding PAK, DAS, CAE, AT, DFL and MRW have received a proportion of their funding from the Department of Health's National Institute for Health Research (NIHR) Biomedical Research Centre for Ophthalmology at Moorfields Eye Hospital and UCL Institute of Ophthalmology.

  • Competing interests AT is a member of the Optovue Inc. users group that received non-financial, technical support.

  • Patient consent Obtained.

  • Ethics approval Moorfields Eye Hospital NHS Trust and local institutional review board.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Any additional unpublished data may be obtained from the corresponding author.

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