Roger A. Goldberg
KOLOA, Hawaii — Even though OCT angiography is a helpful diagnostic tool, there are practical challenges to implementing this technology in practice.
According to the ASRS 2019 Preferences and Trends survey, only 28.6% of U.S. respondents said they used OCTA in clinical practice and found it useful. Thirty-two percent said they did not have access, nor did they intend to gain access any time soon.
“It is a great technology, and it can be helpful in ambiguous cases, but the key takeaway about OCT angiography is: Be patient,” Roger A. Goldberg, MD, MBA, said in a presentation giving a “real-world” perspective on using OCTA at Retina 2020.
There is “an uphill road to climb” to reach widespread adoption of the technology, Goldberg said. For one, data sets are huge, necessitating more powerful computing capabilities.
“If you’re going to upgrade your OCT system, you have to upgrade your computing power as well,” Goldberg said.
And, the learning curve to interpret the data is steep.
Even among retina specialists experienced in reading OCTA, there is wide variability in interpretation of results, Goldberg said, citing a study published in OSLI Retina.
Learning curve challenges to OCTA interpretation include presence of segmentation and projection artifacts, and terminology differences across platforms.
Goldberg has experience with the Zeiss Cirrus 5000 Angioplex SD-OCTA, Zeiss Plex Elite, 100 kHz and 200 kHz SS-OCTA), Heidelberg Spectralis SD-OCTA and limited experience with Optovue AngioVue SD-OCTA.
“For me it doesn’t replace the traditional fluorescein angiography,” Goldberg said. “I do think it will keep improving. I’ve seen it happen in just a few years.” – by Patricia Nale, ELS
Goldberg RA. OCT in the real world. Presented at: Retina 2020; Jan. 19-24, 2020; Koloa, Hawaii.
Prenner S, et al. Ophthalmic Surg Lasers Imaging. 2019;doi:10.3928/23258160-20190605-02.
Disclosure: Goldberg reports receiving grants, equipment and consulting fees from Carl Zeiss Meditec.