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The OSCAR-MP consensus criteria for quality assessment of retinal optical coherence tomography angiography

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Item Type:Article
Title:The OSCAR-MP consensus criteria for quality assessment of retinal optical coherence tomography angiography
Creators Name:Wicklein, R. and Yam, C. and Noll, C. and Aly, L. and Banze, N. and Romahn, E.F. and Wolf, E. and Hemmer, B. and Oertel, F.C. and Zimmermann, H. and Albrecht, P. and Ringelstein, M. and Baumann, C. and Feucht, N. and Penkava, J. and Havla, J. and Gernert, J.A. and Mardin, C. and Vasileiou, E.S. and Van Der Walt, A. and Al-Louzi, O. and Cabello, S. and Vidal-Jordana, A. and Krämer, J. and Wiendl, H. and Preiningerova, J.L. and Ciccarelli, O. and Garcia-Martin, E. and Kana, V. and Calabresi, P.A. and Paul, F. and Saidha, S. and Petzold, A. and Toosy, A.T. and Knier, B.
Abstract:BACKGROUND AND OBJECTIVES: Optical coherence tomography angiography (OCTA) is a noninvasive high-resolution imaging technique for assessing the retinal vasculature and is increasingly used in various ophthalmologic, neuro-ophthalmologic, and neurologic diseases. To date, there are no validated consensus criteria for quality control (QC) of OCTA. Our study aimed to develop criteria for OCTA quality assessment. METHODS: To establish criteria through (1) extensive literature review on OCTA artifacts and image quality to generate standardized and easy-to-apply OCTA QC criteria, (2) application of OCTA QC criteria to evaluate interrater agreement, (3) identification of reasons for interrater disagreement, revision of OCTA QC criteria, development of OCTA QC scoring guide and training set, and (4) validation of QC criteria in an international, interdisciplinary multicenter study. RESULTS: We identified 7 major aspects that affect OCTA quality: (O) obvious problems, (S) signal strength, (C) centration, (A) algorithm failure, (R) retinal pathology, (M) motion artifacts, and (P) projection artifacts. Seven independent raters applied the OSCAR-MP criteria to a set of 40 OCTA scans from people with MS, Sjogren syndrome, and uveitis and healthy individuals. The interrater kappa was substantial (? 0.67). Projection artifacts were the main reason for interrater disagreement. Because artifacts can affect only parts of OCTA images, we agreed that prior definition of a specific region of interest (ROI) is crucial for subsequent OCTA quality assessment. To enhance artifact recognition and interrater agreement on reduced image quality, we designed a scoring guide and OCTA training set. Using these educational tools, 23 raters from 14 different centers reached an almost perfect agreement (? 0.92) for the rejection of poor-quality OCTA images using the OSCAR-MP criteria. DISCUSSION: We propose a 3-step approach for standardized quality control: (1) To define a specific ROI, (2) to assess the occurrence of OCTA artifacts according to the OSCAR-MP criteria, and (3) to evaluate OCTA quality based on the occurrence of different artifacts within the ROI. OSCAR-MP OCTA QC criteria achieved high interrater agreement in an international multicenter study and is a promising QC protocol for application in the context of future clinical trials and studies.
Keywords:Consensus, Fluorescein Angiography, Retina, Retinal Vessels, Optical Coherence Tomography
Source:Neurology Neuroimmunology & Neuroinflammation
Publisher:American Academy of Neurology
Page Range:e200169
Date:November 2023
Official Publication:https://doi.org/10.1212/NXI.0000000000200169
PubMed:View item in PubMed

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