Expression of Motion Artifacts in OCT-Angiography Imaging in Healthy Subjects Using Two Different Devices

Abstract

To compare the expression of motion artifacts in optical coherence tomography angiography (OCT-A) in healthy subjects using two different devices. In this study, 25 eyes of 25 healthy volunteers with no history of any ocular disease or ocular surgery were included. OCT-A imaging was performed using the RTVue XR Avanti (Optovue Inc., Fremont, California, USA) and the Spectralis OCT-A (Heidelberg Engineering, Heidelberg, Deutschland). The macula was imaged twice in each proband with active eye tracking (ET) using a 3 × 3 mm2 or a 10 × 10° scan, respectively. The expression of motion artifact was analyzed by two independent readers in the superficial OCT-angiogram using the Motion Artifact Score (MAS). The signal strength index (SSI) was 73.0 ± 7.8 (Optovue) and 39.6 ± 3.6 (Heidelberg), which is equivalent to 73.0% (Optovue SSImax = 100 = 100%) and 79.2% (SSImax = 50 = 100%) of the maximum quality score. Both devices showed a very good image quality (mean MAS Optovue: 1.32 ± 0.551, mean MAS Heidelberg: 1.7 ± 0.789, p = 0.006). Of all measurements, quilting/banding was found in 20% of Optovue patients (10/50) and 6% of Heidelberg patients (3/50). Stretching was found in 4% of Optovue patients (2/50) and in 6% of Heidelberg patients (3/50). Vessel doubling was only seen in one Optovue angiogram (2%) as well as a displacement (2%). Blink lines only existed in three Heidelberg angiograms (6%). Despite different software and hardware approaches, both devices were able to take high-quality images with a very low prevalence of motion artifacts. Nevertheless, these artifacts still also occur in healthy subjects with good fixation. With regards to MAS, there was a high agreement between the two readers. However, the analysis of artifacts remains complex and requires experience as well as a precise assessment in evaluating OCT-A images.