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Consensus-based recommendations for optical coherence tomography angiography reporting in uveitis
  1. Francesco Pichi1,2,
  2. Ester Carreño3,
  3. Carlos Pavesio4,
  4. Alastair K Denniston5,
  5. Dilraj S Grewal6,
  6. Gabor Deak7,
  7. Moncef Khairallah8,
  8. Matilde Ruiz-Cruz9,
  9. Joao Rafael de Oliveira Dias10,
  10. Alfredo Adan11,
  11. Tomas Burke12,
  12. Alessandro Invernizzi13,
  13. Ariel Schlaen14,
  14. Meng Tian15,
  15. Aniruddha Kishandutt Agarwal16,17,
  16. William R Tucker4,
  17. H Nida Sen18,
  18. Phoebe Lin19,
  19. Lyndell L Lim20,
  20. Kathryn L Pepple21,
  21. Marion R Munk15,22
  1. 1Eye Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE
  2. 2Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio, USA
  3. 3Ocular Inflammation Unit, Ophthalmology Department, Hospital Universitario Fundacion Jimenez Diaz, Madrid, Spain
  4. 4Moorfields Eye Hospital and Biomedical Research Centre, Institute of Ophthalmology, UCL, London, UK
  5. 5Department of Ophthalmology, University Hospitals Birmingham NHSFT, Birmingham, UK
  6. 6Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
  7. 7Department of Ophthalomology, Medical University Vienna, Vienna, Austria
  8. 8Ophthalmology, Fattouma Bourguiba University Hospital, Faculty of Medicine of Monastir, Monastir, Tunisia
  9. 9Asociación Para Evitar la Ceguera en México, Mexico City, Mexico
  10. 10Department of Ophthalmology, Federal University of São Paulo, Paulista Medical School, São Paulo, Brazil
  11. 11Ophthalmology Department, Hospital Clinic, Barcelona, Spain
  12. 12Bristol Eye Hospital, University Hospitals Bristol & Weston NHS Foundation Trust, Bristol, UK
  13. 13Eye Clinic, Department of Clinical Science, Luigi Sacco Hospital, University of Milan, Milan, Italy
  14. 14Ophthalmology Service, Hospital de Clinicas "José de San Martín", Universidad de Buenos Aires, Ciudad Autonoma de Buenos Aires, Argentina
  15. 15Ophthalmology, Inselspital, University Hospital Bern, Bern, Switzerland
  16. 16Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
  17. 17Department of Ophthalmology and Visual Sciences, University of Nebraska Medical Center, Omaha, Nebraska, USA
  18. 18National Eye Institute, National Institutes of Health, Bethesda, Maryland, USA
  19. 19Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, USA
  20. 20Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
  21. 21Ophthalmology, University of Washington, Seattle, Washington, USA
  22. 22Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA
  1. Correspondence to Dr Francesco Pichi, Eye Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, Abu Dhabi, UAE; ilmiticopicchio{at}gmail.com

Abstract

Background/aims To establish a consensus in the nomenclature for reporting optical coherence tomography angiography (OCTA findings in uveitis.

Methods The modified Delphi process consisted of two rounds of electronic questionnaires, followed by a face-to-face meeting conducted virtually. Twenty-one items were included for discussion. The three main areas of discussion were: wide field OCTA (WF-OCTA), nomenclature of OCTA findings and OCTA signal attenuation assessment and measurement. Seventeen specialists in uveitis and retinal imaging were selected by the executive committee to constitute the OCTA nomenclature in Uveitis Delphi Study Group. The study endpoint was defined by the degree of consensus for each question: ‘strong consensus’ was defined as >90% agreement, ‘consensus’ as 85%–90% and ‘near consensus’ as >80% but <85%.

Results There was a strong consensus to apply the term ‘wide field’ to OCTA images measuring over 70° of field of view, to use the terms ‘flow deficit’ and ‘non-detectable flow signal’ to describe abnormal OCTA flow signal secondary to slow flow and to vessels displacement respectively, to use the terms ‘loose’ and ‘dense’ to describe the appearance of inflammatory choroidal neovascularisation, and to use the percentage of flow signal decrease to measure OCTA ischaemia with a threshold greater than or equal to 30% as a ‘large area’.

Conclusions This study sets up consensus recommendations for reporting OCTA findings in uveitis by an expert panel, which may prove suitable for use in routine clinical care and clinical trials.

  • imaging
  • inflammation

Data availability statement

No data are available.

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Data availability statement

No data are available.

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Footnotes

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  • Correction notice This paper has been amended since it was first published. The second author's surname has been corrected. In the abstract and discussion the following section has been updated to read 'to use the terms ’flow deficit’ and ’non- detectable flow signal’ to describe abnormal OCTA flow signal secondary to slow flow and to vessels displacement respectively'.

  • Contributors FP, ECS and MRM: conception or design of the work. FP and ECS: drafting of the work. CP, AKD, DSG, GD, MK, MR-C, JRdOD, AA, TB, AI, AS, MT, AKA, WRT, HNS, PL, LLL, KLP: revising it critically for important intellectual content. CP, AKD, DSG, GD, MK, MR-C, JRdOD, AA, DB, AI, AS, MT, AKA, WRT, HNS, PL, LLL, KLP: final approval of the version to be published. FP is guarantor.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

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