Standardization of OCT Angiography Nomenclature in Retinal Vascular Diseases

Abstract

Objective

To develop a consensus nomenclature for OCT angiography (OCTA) findings in retinal vascular diseases (RVDs).

Design

Expert consensus using standardized online surveys with modified Likert scale.

Participants

Retinal vascular disease imaging experts, OCT biomedical engineers, and the members of the International Retinal Imaging Society (IntRIS)

Methods

A PubMed literature review identified quantitative and qualitative terms forming the basis for a consensus-building process using a modified Delphi method. Agreement levels were categorized as “Accepted” (median ≥6), “Considerable Consensus” (median, 6–7; interquartile range [IQR] ≤3), “Strong Consensus” (median ≥8; IQR ≤2), and “Refined Strong Consensus” (median ≥8, IQR ≤2, with ≥70% of responses in the 8–10 range).

A multidisciplinary expert panel refined the terminology through 3 survey rounds, leading to a final survey conducted by IntRIS members.

Main Outcome Measures

Consensus on OCTA nomenclature in RVD.

Results

The literature review identified 58 relevant papers, yielding 51 quantitative and 108 qualitative terms. A series of 3 surveys was used to refine the nomenclature framework for describing OCTA findings. The selected framework includes a generic term (“OCTA signal”), adjective terms (“presence/absence,” “decreased/increased,” “normal/abnormal”), and descriptive/etiologic terms (“of unknown cause,” “due to blockage,” “due to non-perfusion”).

In the final survey among 44 IntRIS members, the framework achieved strong consensus for overall acceptance (median, 8.0; IQR, 7.0–9.0). The term “OCTA signal” met refined strong consensus criteria (median, 8.0; IQR, 8.0–9.0, with ≥70% of responses in the 8–10 range). Adjective terms, including “absence/presence” and “increased/decreased,” were also rated with strong consensus (median, 8.0; IQR, 7.0–9.0). Similarly, descriptive/etiologic terms achieved strong consensus (median, 8.0; IQR, 7.0–9.0).

Adoption of the framework for clinical practice and scientific reporting was rated with strong consensus (clinical: median, 8.0; IQR, 7.0–9.0; scientific: median, 9.0; IQR, 8.5–10.0).

Conclusions

This study establishes a strong consensus framework for reporting OCTA findings in RVD for clinical and scientific contexts.

Financial Disclosure(s)

Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.