AUTHOR=Diao Kai , Huang Xiaomin , Yao Mingyu , Li Jiawei , Fan Feifei , Pan Hongxian , Yu Jinjin , Yang Yizhou , Lu Weiwei , Lian Hengli , Wang Qinmei , Huang Jinhai , Chen Ruru 

TITLE=Inter-examiner and intra-examiner reliability of optical coherence tomography angiography in vascular density measurement of retinal and choriocapillaris plexuses in healthy children aged 6–15 years

JOURNAL=Frontiers in Medicine

VOLUME=Volume 10 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2023.1161942

DOI=10.3389/fmed.2023.1161942

ISSN=2296-858X

ABSTRACT=Objective: This study aimed to test the inter-examiner and intra-examiner reliability of macular vascular density (VD) measurement of retinal and choriocapillaris plexuses in healthy children using optical coherence tomography angiography (OCTA). 
Materials and Methods: Ninety-two school children were prospectively recruited. Macular OCTA images (6 × 6 mm) were obtained thrice by two examiners using the RTVue-XR Avanti OCT system. The coefficient of variation (COV), intraclass correlation coefficient (ICC), and the Bland–Altman plots were used to evaluate the repeatability and reproducibility.
Results: Ninety participants aged 6–15 years were enrolled; two participants were excluded because of poor image quality. In the retina, the reproducibility and repeatability of VD became poorer from superficial to deep retinal capillary plexus (superficial: COV = 4.61%–11.11%; intermediate: COV = 7.73%–14.15%; deep: COV = 14.60%–32.28%). For both reproducibility and repeatability, the ICC ranged from moderate to high (superficial plexus: ICC = 0.570–0.976; intermediate plexus: ICC = 0.720–0.968; deep plexus: ICC = 0.628–0.954). In the choroid, the inter-examiner reproducibility and intra-examiner repeatability of VD measurement of choriocapillaris were excellent in the macula, fovea, parafovea, and perifovea (COV = 1.00%–6.10%; ICC = 0.856–0.950). The parameters of the foveal avascular zone (FAZ) also showed significant reproducibility and repeatability (COV = 0.01%–0.21%; ICC = 0.743–0.994).
Conclusions: The VD measurements of choriocapillaris and FAZ parameters using OCTA showed excellent inter-examiner and intra-examiner reliability in school children. The reproducibility and repeatability of VD of three retinal capillary plexuses depended on the depth of the retinal capillary plexus.