Optical coherence tomography angiography and indocyanine green angiography for corneal vascularisation

• Published in: British journal of ophthalmology Vol. 100; no. 11; pp. 1557 - 1563
• Main Authors: Ang, Marcus, Cai, Yijun, MacPhee, Becky, Sim, Dawn A, Keane, Pearse A, Sng, Chelvin C A, Egan, Catherine A, Tufail, Adnan, Larkin, Daniel F, Wilkins, Mark R
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 01.11.2016
• Subjects: Coloring Agents - pharmacology; Cornea - blood supply; Cornea - pathology; Corneal Neovascularization - diagnosis; Female; Fluorescein Angiography - methods; Follow-Up Studies; Fundus Oculi; Humans; Indocyanine Green - pharmacology; Male; Middle Aged; Reproducibility of Results; Retrospective Studies; Tomography, Optical Coherence - methods; Neovascularisation; Cornea; Imaging
• ISSN: 0007-1161; 1468-2079
• DOI: 10.1136/bjophthalmol-2015-307706

Background/AimTo describe an optical coherence tomography angiography (OCTA) system adapted for anterior segment imaging, compared with indocyanine green angiography (ICGA) in eyes with corneal vascularisation.MethodsRetrospective study of subjects with corneal vascularisation secondary to microbial keratitis who had OCTA scans performed using a commercially available split-spectrum amplitude-decorrelation algorithm angiography system (AngioVue; Optovue Inc., Fremont, California, USA) and ICGA images (Spectralis; Heidelberg Engineering, Heidelberg, Germany). The agreement between OCTA and ICGA techniques in terms of area of vascularisation measured, using Bland–Altman 95% limits of agreement (LOA).ResultsWe compared the area of corneal vascularisation in 64 scan images (eight eyes, four scans for each angiography technique). In our series, the overall mean area of vascularisation from the ICGA scans was 0.49±0.34 mm2 and OCTA scans was 0.51±0.36 mm2. We obtained substantial repeatability in terms of image quality score (κ=0.80) for all OCTA scans. The agreement between OCTA and ICGA scans was good, although ICGA measured a smaller area compared with the OCTA with a mean difference of −0.03 mm2 (95% CI −0.07 to 0.01). The LOA ranged from a lower limit of −0.27 (95% CI −0.34 to −0.19) to an upper limit of 0.20 (95% CI 0.13 to 0.28, p=0.127).ConclusionsWe found that rapid, non-contact OCTA adapted for the cornea was comparable with ICGA for measurement of the area of corneal vascularisation in this pilot clinical study. Further prospective studies are required to confirm if this relatively new imaging technique may be further developed to replace invasive angiography techniques for the anterior segment.