Comparative analysis of choriocapillaris visualization across various optical coherence tomography systems

Abstract

Purpose

To evaluate the variability in choriocapillaris (CC) blood flow measurements across different optical coherence tomography angiography (OCTA) systems.

Methods

A cross-sectional study with 13 healthy volunteers (10 females, 26 [24;27] years). Central 3 × 3 mm OCTA were obtained using: HRA + OCT Spectralis, Heidelberg Engineering; DRI OCT Triton, Topcon (software versions IMAGEnet 6 1.36 and 1.38); Mocean 4000, Moptim; Avanti RTVue-XR, Optovue; Solix, Optovue; Revo NX130, Optopol Technology. CC flow parameters (flow deficit (FD) number, FD density, and mean FD area) were analysed using the Phansalkar method. Binarization windows and FD thresholds were calculated individually for each device.

Results

OCTA images exhibited significant variability in FD number (F(6, 85) = 8.062, p < 0.001), FD density (F(6, 99) = 3.957, p = 0.028), and mean FD area (F(6, 99) = 58.936, p < 0.001). Strong correlation was found only between Avanti and DRI OCT Triton (ver. 1.38) for FD number (r = 0.955, p = 0.017) and FD density (r = 0.912, p = 0.033). ICC demonstrated poor agreement among devices.

Conclusion

Significant differences in CC visualization across devices highlight OCTA limitations. Device-specific algorithms are needed to ensure accurate CC evaluation, and quantitative assessments should be interpreted with caution in clinical and research settings.