OCT-angiography: A qualitative and quantitative comparison of 4 OCT-A devices

Purpose To compare the quality of four OCT-angiography(OCT-A) modules. Method The retina of nineteen healthy volunteers were scanned with four OCT-devices (Topcon DRI-OCT Triton Swept-source OCT, Optovue RTVue-XR, a prototype Spectralis OCT2, Heidelberg-Engineering and Zeiss Cirrus 5000-HD-OCT). The device-software generated en-face OCT-A images of the superficial (SCP) and deep capillary plexuses (DCP) were evaluated and scored by 3 independent retinal imaging experts. The SCP vessel density was assessed using Angiotool-software. After the inter-grader reliability assessment, a consensus grading was performed and the modules were ranked based on their scoring. Results There was no significant difference in the vessel density among the modules (Zeiss 48.7 +/- 4%, Optovue 47.9 +/- 3%, Topcon 48.3 +/- 2%, Heidelberg 46.5 +/- 4%, p = 0.2). The numbers of discernible vessel-bifurcations differed significantly on each module (Zeiss 2 +/- 0.9 bifurcations, Optovue 2.5 +/- 1.2, Topcon 1.3 +/- 0.7 and Heidelberg 0.5 +/- 0.6, p <= 0.001). The ranking of each module differed depending on the evaluated parameter. In the overall ranking, the Zeiss module was superior and in 90% better than the median (Bonferroni corrected p-value = 0.04). Optovue was better than the median in 60%, Topcon in 40% and Heidelberg module in 10%, however these differences were not statistically significant. Conclusion Each of the four evaluated OCT-A modules had particular strengths, which differentiated it from their competitors.