Comparison of retina specialist preferences regarding spectral-domain and swept-source optical coherence tomography angiography

Abstract

Purpose

The aim of this study was to compare physician preferences regarding the commercially available spectral-domain (SD) optical coherence tomography angiography (OCTA) and swept-source (SS) OCTA prototype device.

Design

Comparative analysis of diagnostic instruments was performed.

Patients and methods

Subjects at the University of Washington Eye Institute and Harborview Medical Center were prospectively recruited and imaged with the Zeiss SD OCTA (HD-5000, Angioplex) and Zeiss SS OCTA (Plex Elite, Everest) devices on the same day. The study included 10 eyes from 10 subjects diagnosed with a retinal/choroidal disease. Deidentified images were compiled into a survey and sent to retina specialists in various countries. The survey presented masked SD and SS images of each eye for each retinal sublayer side by side. Respondents were asked about their image preference and impact on clinical management. A priori and post hoc preferences for SD vs SS were collected.

Results

Fifty-four retina specialists responded to the survey. Median years in practice was 3.00 (interquartile range [IQR] 1.50–17.00). At baseline, 23 (48%) physicians owned an OCTA machine. The majority of physician responses showed a preference for the SS over SD OCTA, independent of the retinal pathology shown (n=454 overall responses, 74%). Nevertheless, the majority indicated that both SD and SS would be equally valuable in informing clinical decisions (n=374 overall responses, 61%).

Conclusion

These findings indicate that the majority of retina specialists surveyed prefer SS over SD OCTA based on image quality, regardless of the retinal pathology shown. Regarding the clinical utility of each modality, the majority of physicians perceive SD and SS as equally effective.

Keywords:

• swept-source optical coherence tomography angiography
• spectral-domain optical coherence tomography angiography
• physician preference

Supplementary materials

Figure S1 Screenshot of questionnaire at the beginning of the survey.

Note: Created by Aaron Y Lee and Cecilia S Lee, University of Washington.

Abbreviations: OCTA, optical coherence tomography angiography; SD, spectral domain; SS, swept source.

Figure S2 Screenshot of questionnaire following each case.

Note: Created by Aaron Y Lee and Cecilia S Lee, University of Washington.

Abbreviations: OCTA, optical coherence tomography angiography; SD, spectral domain; SS, swept source.

Acknowledgments

The authors would like to acknowledge Thellea Leveque MD MPH at the Department of Ophthalmology, University of Washington, for her contribution with OCT imaging of a patient in the study. The content of this manuscript has not been previously presented at a meeting. This work was supported by the National Eye Institute, Bethesda, MD [K23EY02492] (CSL), the Research to Prevent Blindness, Inc., New York, NY (CSL, AYL, KR), and Carl Zeiss Meditec, Inc. The funding source had no role in the design and conduct of the study’s collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Author contributions

CSL had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: AYL, CSL. Acquisition, analysis, or interpretation of data: AYL, CSL, GLS, QZ, KR. Drafting of the manuscript: GLS. Critical revision of the manuscript for important intellectual content: AYL, CSL, KR, QZ, DMB. Statistical analysis: AYL, CSL, GSL. Obtaining funding: AYL, CSL, KR. Administrative, technical, or material support: AYL, KR, QZ. Study supervision: AYL, CSL. All authors contributed toward data analysis, drafting and critically revising the paper, and agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in this work.