Advancing optical coherence tomography angiography to the clinic.

Abstract

Optical coherence tomography (OCT) angiography (OCTA) is a new clinical technology that advances the capabilities of OCT imaging by adding the ability to readily visualize vascular anatomy down to the capillary scale. With this level of detail, OCTA can be used to identify many important vascular pathologies such as capillary dropout, microaneurysms, or neovascularization. Because it offers high-resolution, high-contrast imaging of these and similar features, OCTA is useful not just for visualization but also for quantification. Quantification is a powerful feature that enables the potential for diagnostics, staging, evaluation of treatment response, and patient monitoring in a more rigorous way than simple observation. In this review, we will examine several OCTA measurements with either demonstrated clinical utility or clinical potential through the lens of three prevalent blinding diseases: diabetic retinopathy, age-related macular degeneration, and glaucoma. We will discuss the merits of these various measurements and care that should be taken in their interpretation and analyze their role in patient management.