Munk Marion R, Kashani Amir H, Tadayoni Ramin, Korobelnik Jean-Francois, Wolf Sebastian, Pichi Francesco, Koh Adrian, Ishibazawa Akihiro, Gaudric Alain, Loewenstein Anat, Lumbroso Bruno, Ferrara Daniela, Sarraf David, Wong David T, Skondra Dimitra, Rodriguez Francisco J, Staurenghi Giovanni, Pearce Ian, Kim Judy E, Freund K Bailey, Parodi Maurizio Battaglia, Waheed Nadia K, Rosen Richard, Spaide Richard F, Nakao Shintaro, Sadda SriniVas, Vujosevic Stela, Wong Tien Yin, Murata Toshinori, Chakravarthy Usha, Ogura Yuichiro, Huf Wolfgang, Tian Meng
Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Bern Photographic Reading Center, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, Maryland.
Ophthalmol Retina. 2022 Sep;6(9):753-761. doi: 10.1016/j.oret.2022.02.007. Epub 2022 Feb 22.
To develop a consensus nomenclature for reporting OCT angiography (OCTA) findings in retinal vascular disease (e.g., diabetic retinopathy, retinal vein occlusion) by international experts.
Delphi-based survey.
SUBJECTS, PARTICIPANTS, AND/OR CONTROLS: Twenty-five retinal vascular disease and OCTA imaging experts.
METHODS, INTERVENTION, OR TESTING: A Delphi method of consensus development was used, comprising 2 rounds of online questionnaires, followed by a face-to-face meeting conducted virtually. Twenty-five experts in retinal vascular disease and retinal OCTA imaging were selected to constitute the OCTA Nomenclature in Delphi Study Group for retinal vascular disease. The 4 main areas of consensus were: definition of the parameters of "wide-field (WF)" OCTA, measurement of decreased vascular flow on conventional and WF-OCTA, nomenclature of OCTA findings, and OCTA in retinal vascular disease management and staging. The study end point was defined by the degree of consensus for each question: "strong consensus" was defined as ≥85% agreement, "consensus" as 80% to 84%, and "near consensus" as 70% to 79%.
Consensus and near consensus on OCTA nomenclature in retinal vascular disease.
A consensus was reached that a meaningful change in percentage of flow on WF-OCTA imaging should be an increase or decrease ≥30% of the absolute imaged area of flow signal and that a "large area" of WF-OCTA reduced flow signal should also be defined as ≥30% of the absolute imaged area. The presence of new vessels and intraretinal microvascular abnormalities, the foveal avascular zone parameters, the presence and amount of "no-flow areas," and the assessment of vessel density in various retinal layers should be added for the staging and classification of diabetic retinopathy. Decreased flow ≥30% of the absolute imaged area should define an ischemic central retinal vein occlusion. Several other items did not meet consensus requirements or were rejected in the final discussion round.
This study provides international consensus recommendations for reporting OCTA findings in retinal vascular disease, which may help to improve the interpretability and description in clinic and clinical trials. Further validation in these settings is warranted and ongoing. Efforts are continuing to address unresolved questions.
由国际专家制定视网膜血管疾病（如糖尿病性视网膜病变、视网膜静脉阻塞）中报告光学相干断层扫描血管造影（OCTA）结果的共识命名法。
基于德尔菲法的调查。
受试者、参与者和/或对照：25位视网膜血管疾病和OCTA成像专家。
方法、干预或测试：采用德尔菲共识制定方法，包括两轮在线问卷，随后进行虚拟面对面会议。挑选25位视网膜血管疾病和视网膜OCTA成像专家组成视网膜血管疾病德尔菲研究组OCTA命名法小组。共识的4个主要领域为：“广角（WF）”OCTA参数的定义、传统OCTA和WF-OCTA上血管血流减少的测量、OCTA结果的命名以及视网膜血管疾病管理和分期中的OCTA。研究终点由每个问题的共识程度定义：“强共识”定义为≥85%的一致意见，“共识”为80%至84%，“接近共识”为70%至79%。
视网膜血管疾病中OCTA命名法的共识和接近共识情况。
达成的共识是，WF-OCTA成像上血流百分比的有意义变化应为血流信号绝对成像面积增加或减少≥30%，并且WF-OCTA血流信号减少的“大面积”也应定义为绝对成像面积的≥30%。糖尿病性视网膜病变的分期和分类应增加新生血管和视网膜内微血管异常的存在情况、黄斑无血管区参数、“无血流区”的存在和数量以及不同视网膜层血管密度的评估。绝对成像面积血流减少≥30%应定义为缺血性中央视网膜静脉阻塞。其他几个项目未达到共识要求或在最终讨论轮中被否决。
本研究为视网膜血管疾病中报告OCTA结果提供了国际共识建议，这可能有助于提高临床和临床试验中的可解释性及描述。在这些环境中进行进一步验证是必要的且正在进行中。正在继续努力解决未解决的问题。
