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Intrasession repeatability and intersession reproducibility of peripapillary OCTA vessel parameters in non-glaucomatous and glaucomatous eyes
  1. Jae Chang Lee1,
  2. Dominic J Grisafe1,
  3. Bruce Burkemper1,
  4. Brenda R Chang1,
  5. Xiao Zhou2,
  6. Zhongdi Chu2,
  7. Ali Fard3,
  8. Mary Durbin3,
  9. Brandon J Wong1,
  10. Brian J Song1,
  11. Benjamin Y Xu1,
  12. Ruikang Wang2,
  13. Grace M Richter1
  1. 1 Ophthalmology, University of Southern California Keck School of Medicine, Los Angeles, California, USA
  2. 2 Bioengineering, University of Washington, Seattle, Washington, USA
  3. 3 Carl Zeiss Meditec Inc, Dublin, California, USA
  1. Correspondence to Grace M Richter, Ophthalmology, University of Southern California Keck School of Medicine, 1450 San Pablo St, Suite 4700, Los Angeles, CA 90033, USA; grace.richter{at}


Objective To compare intrasession repeatability versus intersession reproducibility of the peripapillary vessel parameters using optical microangiography–based optical coherence tomography angiography (OCTA) in non-glaucomatous and glaucomatous eyes.

Methods In an observational, longitudinal study, peripapillary OCTA scans were collected to evaluate intrasession repeatability and intersession reproducibility using within-eye coefficient of variation (CVW) and intraclass correlation coefficient (ICC). Images were quantified using a custom research–oriented quantification software calculating vessel area density (VAD) and flux and a commercially developed, clinic-oriented quantification software (Cirrus 11.0, Carl Zeiss Meditec) calculating perfusion density (PD) and flux index (FI). Effect of signal strength on the reliability of OCTA parameters was also evaluated.

Results Among 120 non-glaucomatous eyes, intrasession CVW were 4.2% for VAD, 5.3% for flux, 1.5% for PD and 2.0% for FI. The intersession CVW were 6.5% for VAD, 8.0% for flux, 2.0% for PD and 3.2% for FI. The intrasession ICC ranged from 0.928 to 0.945, and intersession ICC ranged from 0.811 to 0.866. From 118 glaucomatous eyes, intrasession CVW was 9.0% for VAD, 10.3% for flux, 1.7% for PD and 2.3% for FI. The intersession CVW was 12.1% for VAD, 14.2% for flux, 2.3% for PD and 3.5% for FI. The intrasession ICC ranged from 0.904 to 0.972, and intersession ICC ranged from 0.855 to 0.955. Signal strength was significantly positively associated with OCTA vessel parameters (p<0.0001) for both groups.

Conclusion Peripapillary OCTA vessel parameters had greater intrasession repeatability compared to intersession reproducibility in both non-glaucomatous and glaucomatous eyes. The built-in commercially developed quantification software demonstrated greater agreement than the custom research–oriented quantification software.

  • Glaucoma
  • Imaging
  • Optic Nerve

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  • Contributors GMR conceptualised the study idea. GMR, DJG and BB designed the study. JCL and BRC collected and managed the data. XZ, ZC, AF, MD and RW developed quantification software and/or provided associated technical expertise. JCL, BRC, AF, XZ, ZC and RW contributed to image analysis. GMR, BJW, BJS and BYX were the glaucoma specialists who recruited study participants and performed glaucoma diagnosis. JCL, DJG and BB carried out the statistical analyses. DJG, BB, JCL and GMR performed critical review of the data analyses and results. JCL and GMR wrote the manuscript. JCL, DJG, BB, BRC, XZ, ZC, AF, MD, BJW, BJS, BYX, RW and GMR contributed to critical revisions of the manuscript.

  • Funding This work was supported by National Institutes of Health Grants (5K23EY027855-03, GMR) and Multidisciplinary Research Training in Gerontology, National Institute on Aging (NIA T32AG000037, DJG).

  • Competing interests GMR: Carl Zeiss Meditec—research support; RW: Carl Zeiss Meditec—research support, consultant, patent; AF: Carl Zeiss Meditec—employment; MD: Carl Zeiss Meditec—employment; the remaining authors declare no conflict of interest.

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

  • Data availability statement Data are available upon reasonable request.

  • Meeting presentation Part of the data presented in the current manuscript was previously presented at the Association for Research in Vision and Ophthalmology Annual Meeting 2020.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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