Evaluation of Accuracy and Agreement of Optical Coherence Tomography Angiography Interpretation of Common Retinal Findings and Diagnoses.

PURPOSE To evaluate the accuracy and agreement of OCTA interpretation in cases of common retinal findings and diagnoses, and evaluate the effect of the OCT B-scans on OCTA interpretations. METHODS A case-series study, consisting of a questionnaire with 8 cases demonstrating common retinal conditions of normal, age-related macular degeneration (AMD) and diabetic retinopathy (DR). Each case included OCTA images, and 58 participants were asked to identify retinal findings and provide a diagnosis. Following OCTA interpretation, the corresponding OCT B-scans were revealed and participants were asked again to identify retinal findings and provide a diagnosis. Rates of accuracy and agreement for each condition were analyzed. RESULTS Overall rates of accurate diagnosis and identification of retinal findings were 37.4% and 61.6%, respectively. Following addition of the OCT B-scans, rates increased to 61.6% and 79.4%, respectively (p<0.001 for both). A significant improvement in correct interpretation occurred in the normal and AMD cases, but not DR cases. There was no correlation with length of experience or self-reported familiarity with OCTA. DISCUSSION Considerable variability exists in OCTA interpretation, with mediocre rates of accuracy and agreement between clinicians. Increased familiarity as well as future automation advances will be needed to improve OCTA interpretation accuracy and uniformity.