title: A review of optical coherence tomography angiography (OCTA).
abstract: Optical coherence tomography angiography (OCTA) is a new, non-invasive imaging technique that generates volumetric angiography images in a matter of seconds. This is a nascent technology with a potential wide applicability for retinal vascular disease. At present, level 1 evidence of the technology's clinical applications doesn't exist. In this paper, we introduce the technology, review the available English language publications regarding OCTA, and compare it with the current angiographic gold standards, fluorescein angiography (FA) and indocyanine green angiography (ICGA). Finally we summarize its potential application to retinal vascular diseases. OCTA is quick and non-invasive, and provides volumetric data with the clinical capability of specifically localizing and delineating pathology along with the ability to show both structural and blood flow information in tandem. Its current limitations include a relatively small field of view, inability to show leakage, and proclivity for image artifact due to patient movement/blinking. Published studies hint at OCTA's potential efficacy in the evaluation of common ophthalmologic diseases such age related macular degeneration (AMD), diabetic retinopathy, artery and vein occlusions, and glaucoma. OCTA can detect changes in choroidal blood vessel flow and can elucidate the presence of choroidal neovascularization (CNV) in a variety of conditions but especially in AMD. It provides a highly detailed view of the retinal vasculature, which allows for accurate delineation of the foveal avascular zone (FAZ) in diabetic eyes and detection of subtle microvascular abnormalities in diabetic and vascular occlusive eyes. Optic disc perfusion in glaucomatous eyes is notable as well on OCTA. Further studies are needed to more definitively determine OCTA's utility in the clinical setting and to establish if this technology may offer a non-invasive option of visualizing the retinal vasculature in detail.
authors.affiliation: New England Eye Center and Tufts Medical Center, Tufts University, 260 Tremont Street, Biewend Building, 9 - 11th Floor, Boston, MA 02116 USA ; grid.116068.80000000123412786Department of Electrical Engineering and Computer Science, and Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, MA 02139 USA.
authors.forename: Talisa E
authors.initials: TE
authors.lastname: de Carlo
authors.affiliation: grid.411249.b0000000105147202Department of Ophthalmology, Federal University of São Paulo, Escola Paulista de Medicina, São Paulo, Brazil ; Retina Service, Neovista Eye Center, Americana, Brazil.
authors.forename: Andre
authors.initials: A
authors.lastname: Romano
authors.affiliation: New England Eye Center and Tufts Medical Center, Tufts University, 260 Tremont Street, Biewend Building, 9 - 11th Floor, Boston, MA 02116 USA.
authors.forename: Nadia K
authors.initials: NK
authors.lastname: Waheed
authors.affiliation: New England Eye Center and Tufts Medical Center, Tufts University, 260 Tremont Street, Biewend Building, 9 - 11th Floor, Boston, MA 02116 USA.
authors.forename: Jay S
authors.initials: JS
authors.lastname: Duker
keywords: Age-related macular degeneration; Diabetic retinopathy; Fluorescein angiography; Glaucoma; Indocyanine angiography; Optic disc; Optical coherence tomography angiography; Retina; Retinal vessel occlusion