title: Quantification of Vessel Density in Retinal Optical Coherence Tomography Angiography Images Using Local Fractal Dimension.
abstract: OBJECTIVE
  To evaluate a fully automated local fractal dimension method to quantify vessel density and foveal avascular zone (FAZ) area in optical coherence tomography angiography (OCTA) images.
  
  
  METHODS
  Fifty-two healthy Asian Indian eyes underwent imaging prospectively with OCTA system. Superficial and deep retinal vascular plexus was imaged. Local fractal analysis was applied to the OCTA images. A scan area of 3 × 3 mm was selected in the superficial and deep retinal layers. Foveal avascular zone area and vessel density were quantified in circular and sectoral zones around the fovea. A unique contour map of vessel density and dropout zones was developed to perform regional comparisons.
  
  
  RESULTS
  Foveal avascular zone of superficial (0.35 ± 0.013 mm2) and deep (0.49 ± 0.012 mm2) retinal vascular plexus was segmented. The agreement between the manually segmented and local fractal dimension segmented FAZ area was 0.97 (95% confidence interval [CI]: 0.94-0.98) and did not change significantly with age (P = 0.94 and 0.21, respectively). The vessel density was greater in the deep than the superficial retinal vascular plexus (P < 0.0001). When the image was subdivided into sectors around the FAZ, inferior sector had greater vessel density than the others (temporal, superior, and nasal) in both superficial and deep retinal vascular plexus (P < 0.05). These observations were similar to recent studies on animal retinal vasculature map.
  
  
  CONCLUSIONS
  A novel implementation of local fractal dimension to calculate vessel density and FAZ area was demonstrated. Age did not impact vessel density but sectoral analyses showed greater vessel density in the inferior zone.
authors.affiliation: Retina Department Narayana Nethralaya Foundation, Bangalore, India.
authors.forename: Santosh G K
authors.initials: SG
authors.lastname: Gadde
authors.affiliation: Imaging, Biomechanics and Mathematical Modeling Solutions, Narayana Nethralaya Foundation, Bangalore, India.
authors.forename: Neha
authors.initials: N
authors.lastname: Anegondi
authors.affiliation: Retina Department Narayana Nethralaya Foundation, Bangalore, India.
authors.forename: Devanshi
authors.initials: D
authors.lastname: Bhanushali
authors.affiliation: Retina Department Narayana Nethralaya Foundation, Bangalore, India.
authors.forename: Lavanya
authors.initials: L
authors.lastname: Chidambara
authors.affiliation: Retina Department Narayana Nethralaya Foundation, Bangalore, India.
authors.forename: Naresh Kumar
authors.initials: NK
authors.lastname: Yadav
authors.affiliation: Retina Department Narayana Nethralaya Foundation, Bangalore, India.
authors.forename: Aruj
authors.initials: A
authors.lastname: Khurana
authors.affiliation: Imaging, Biomechanics and Mathematical Modeling Solutions, Narayana Nethralaya Foundation, Bangalore, India.
authors.forename: Abhijit
authors.initials: A
authors.lastname: Sinha Roy
mesh_terms: D005451:Fluorescein Angiography / Q000379:methods*; D017709:Fractals; D005654:Fundus Oculi; D006801:Humans; D015203:Reproducibility of Results; D012171:Retinal Vessels / Q000166:cytology*; D041623:Tomography, Optical Coherence / Q000379:methods*