Efficient method to suppress artifacts caused by tissue hyper-reflections in optical microangiography of retina in vivo.

Optical microangiography (OMAG) is an optical coherence tomography (OCT)-based imaging technique that is capable of achieving the angiographic imaging of biological tissues in vivo with a high imaging resolution and no need for dye injection. OMAG has a potential to become a clinical tool for the diagnosis and treatment monitoring of various retinopathies. In principle, OMAG extracts blood flow information based on a direct differentiation of complex or intensity OCT signals between repeated B-scans acquired at the same cross section, which is sensitive to blood cell movement. In practice, this method is prone to artifacts due to tissue hyper-reflection, commonly seen in retinal diseases such as diabetic retinopathy. In this paper, we propose a novel method to suppress the artifacts induced by hyper-reflection. We propose to scale OMAG flow signals by a weighting factor that is motion-sensitive but hyper-reflection insensitive. We show that this simple weighting approach is effective in suppressing the artifacts due to tissue hyper-reflections while still maintaining the detected capillary networks with high fidelity, especially in deeper retina. The effectiveness of the proposed technique is demonstrated by a phantom study and case studies on patients' eyes with hyper-reflective foci. Finally we discuss potential applications of this technique.