Standardization of OCT Angiography Nomenclature in Retinal Vascular Diseases: Consensus-Based Recommendations

Collaborators, Affiliations

Collaborators

International Retinal Imaging Society Research Group:
Carroll Joseph¹³, Say Emil Anthony¹⁴, De Carlo Forest Talisa¹⁵, Ramtohul Prithvi¹⁶, Fung Adrian¹⁷, Borrelli Enrico¹⁸, Bhende Muna¹⁹, Querques Giuseppe²⁰, Theelen Thomas²¹, Rao Chetan²², Agarwal Aniruddha²³, Cicinelli Maria Vittoria²⁴, Jung Jesse²⁵, Juan Carlos Gutiérrez Hernández²⁶, Chen Fred²⁷, Iovino Claudio²⁸, Arevalo J Fernando²⁹, Gaudric Alain³⁰, Hartnett M Elizabeth³¹, Schmitz-Valckenberg Steffen³², Rosenfeld Philip³³, Boyer David³⁴, Cheung Chui Ming Gemmy³⁵, Domalpally Amitha³⁶, Mano Fukutaro³⁷, Khalid Hagar³⁸, Moussa Magdy³⁹, Bacci Tommaso⁴⁰, Rodriguez Francisco J⁴¹, Huemer Josef⁴², Souied Eric⁴³, Tsui Edmund⁴⁴, Holz Frank⁴⁵, Byon Iksoo⁴⁶, Ach Thomas⁴⁷, Dysli Chantal⁴⁸, Bousquet Elodie⁴⁹, Falavarjani Khalil⁵⁰, Krivosic Valérie⁴⁹, Tan Colin S⁵¹, Sivaprasad Sobha⁵², Claudia Fabiani⁵³, Crincoli Emanuele⁵⁴, Chiosi Flavia⁵⁵

Affiliations

¹ Gutblick Practice Group, Pfäffikon, Switzerland; Department of Ophthalmology, Inselspital, University Hospital Bern, Bern, Switzerland; Feinberg School of Medicine, Northwestern University Chicago, Chicago, Illinois. Electronic address: marion_munk@hotmail.com.
² Gutblick Practice Group, Pfäffikon, Switzerland; Stadtspital Zürich, Zürich, Switzerland; Department of Ophthalmology, Semmelweis University, Budapest, Hungary.
³ Medical Retina Department, Moorfields Eye Hospital National Health Service Foundation Trust, London, United Kingdom; Vitreous Retina Macula Consultants New York, New York.
⁴ Department of Ophthalmology, Inselspital, University Hospital Bern, Bern, Switzerland.
⁵ Vitreous Retina Macula Consultants New York, New York; Department of Ophthalmology, New York University Grossman School of Medicine, New York, New York.
⁶ Doheny Eye Institute, Pasadena, California; University of California - Los Angeles, Los Angeles, California.
⁷ Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom.
⁸ Department of Bioengineering, University of Washington, Seattle, Washington; Department of Ophthalmology, University of Washington, Seattle, Washington.
⁹ Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria.
¹⁰ Department of Ophthalmology and Visual Sciences, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, Alabama.
¹¹ Joslin Diabetes Center, Beetham Eye Institute, Harvard Department of Ophthalmology, Boston, Massachusetts.
¹² Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland.
¹³ Department of Ophthalmology & Visual Sciences, Medical College of Wisconsin, Milwaukee, WI, United States.
¹⁴ South Carolina Retina Institute, Conway, South Carolina.
¹⁵ Sue Anschutz-Rodgers Eye Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
¹⁶ Ophthalmology Department, Hopital Nord, Aix Marseille University, Marseille, France.
¹⁷ Westmead and Central (Save Sight Institute) Clinical Schools, Specialty of Clinical Ophthalmology and Eye Health, University of Sydney, Sydney, Australia; Department of Ophthalmology, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia; Department of Ophthalmology, Westmead Hospital, Sydney, New South Wales, Australia.
¹⁸ Department of Surgical Sciences, University of Turin, Turin, Italy; Department of Ophthalmology, "City of Health and Science" Hospital, Turin, Italy.
¹⁹ Shri Bhagwan Mahavir Vitreoretinal Services, Medical Research Foundation, Chennai, Tamil Nadu, India.
²⁰ UniSR - IRCCS San Raffaele Scientific Institute, Milan, Italy.
²¹ Radboud University Medical Center (Radboudumc), Dept. of Ophthalmology, Nijmegen, the Netherlands.
²² Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, Tamil Nadu, India.
²³ The Eye Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates; Cleveland Clinic Lerner College of Medicine, Cleveland, OH, USA.
²⁴ School of Medicine, Vita-Salute San Raffaele University, Milan, Italy; Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy.
²⁵ East Bay Retina Consultants, Inc. Department of Ophthalmology, University of California San Francisco, USA.
²⁶ Universidad de Costa Rica, Caja Costarricense del Seguro Social, Hospital Clinica Biblica, Costa Rica.
²⁷ Centre of Ophthalmology and Visual Science (incorporating Lions Eye Institute), The University of Western Australia, Western Australia, Australia; Ophthalmology, Department of Surgery, University of Melbourne, East Melbourne, Victoria, Australia; Department of Ophthalmology, Royal Perth Hospital, Perth, Western Australia, Australia; Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia.
²⁸ Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy.
²⁹ Johns Hopkins University, Wilmer Eye Institute, Baltimore, MD, USA.
³⁰ Université Paris Cité, Hopital Lariboisière APHP, Centre d'Imagerie et Laser, Paris, France.
³¹ Byers Eye Institute of Stanford University, USA.
³² John A. Moran Eye Center, University of Utah, USA; Department of Ophthalmology, University of Bonn, Germany.
³³ Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, USA.
³⁴ Partner Retina Vitreous Associates, USA; Adjunct Clinical Professor of Ophthalmology, University of Southern California/Keck School of Medicine, USA.
³⁵ Singapore National Eye Center, Singapore.
³⁶ Wisconsin Reading Center, University of Wisconsin, Madison, USA.
³⁷ Department of Ophthalmology, Kindai University Faculty of Medicine, Japan.
³⁸ NIHR Moorfields Biomedical Research Centre, Moorfields Eye Hospital, London, UK; Ophthalmology Department, Tanta University, Egypt.
³⁹ Professor of Ophthalmology, Tanta University, Egypt.
⁴⁰ Ophthalmology Unit, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena University Hospital, Siena, Italy.
⁴¹ Fundonal, Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogota, DC, Colombia.
⁴² Moorfields Eye Hospital NHS Foundation Trust, London, UK; Department of Ophthalmology and Optometry, Kepler University Hospital, Johannes Kepler University, Linz, Austria.
⁴³ University Paris Est Creteil, France.
⁴⁴ UCLA Stein Eye Institute, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
⁴⁵ University of Bonn, Germany.
⁴⁶ Pusan National University Hospital, Pusan National University School of Medicine, South Korea.
⁴⁷ University Hospital Bonn, Department of Ophthalmology, Germany.
⁴⁸ Department of Ophthalmology, University Hospital Bern, Switzerland.
⁴⁹ Department of Ophthalmology, University of Paris Cité, Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris, France.
⁵⁰ Eye Research Center, The Five Senses Health Institute, Iran University of Medical Sciences, Iran.
⁵¹ National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore.
⁵² NIHR Moorfields Biomedical Research Centre, Moorfields Eye Hospital, London, UK.
⁵³ Ophthalmology Unit, Department of Medicine, Surgery and Neurosciences, University of Siena and Azienda Ospedaliero-Universitaria Senese (European Reference Network [ERN] for Rare Immunodeficiency, Autoinflammatory, and Autoimmune Diseases [RITA] Center), Policlinico "Le Scotte," viale Bracci 16, 53100 Siena, Italy.
⁵⁴ Policlinico Universitario Agostino Gemelli, Rome, Italy.
⁵⁵ A.O.R.N. dei Colli - Monaldi Hospital, Napoli, Italy.

PMID: 39894444
DOI: 10.1016/j.oret.2025.01.015

Free article

Review

Standardization of OCT Angiography Nomenclature in Retinal Vascular Diseases: Consensus-Based Recommendations

Marion R Munk et al. Ophthalmol Retina. 2025 Jul.

Free article

. 2025 Jul;9(7):645-654.

doi: 10.1016/j.oret.2025.01.015. Epub 2025 Jan 31.

Collaborators

International Retinal Imaging Society Research Group:
Carroll Joseph¹³, Say Emil Anthony¹⁴, De Carlo Forest Talisa¹⁵, Ramtohul Prithvi¹⁶, Fung Adrian¹⁷, Borrelli Enrico¹⁸, Bhende Muna¹⁹, Querques Giuseppe²⁰, Theelen Thomas²¹, Rao Chetan²², Agarwal Aniruddha²³, Cicinelli Maria Vittoria²⁴, Jung Jesse²⁵, Juan Carlos Gutiérrez Hernández²⁶, Chen Fred²⁷, Iovino Claudio²⁸, Arevalo J Fernando²⁹, Gaudric Alain³⁰, Hartnett M Elizabeth³¹, Schmitz-Valckenberg Steffen³², Rosenfeld Philip³³, Boyer David³⁴, Cheung Chui Ming Gemmy³⁵, Domalpally Amitha³⁶, Mano Fukutaro³⁷, Khalid Hagar³⁸, Moussa Magdy³⁹, Bacci Tommaso⁴⁰, Rodriguez Francisco J⁴¹, Huemer Josef⁴², Souied Eric⁴³, Tsui Edmund⁴⁴, Holz Frank⁴⁵, Byon Iksoo⁴⁶, Ach Thomas⁴⁷, Dysli Chantal⁴⁸, Bousquet Elodie⁴⁹, Falavarjani Khalil⁵⁰, Krivosic Valérie⁴⁹, Tan Colin S⁵¹, Sivaprasad Sobha⁵², Claudia Fabiani⁵³, Crincoli Emanuele⁵⁴, Chiosi Flavia⁵⁵

Affiliations

¹ Gutblick Practice Group, Pfäffikon, Switzerland; Department of Ophthalmology, Inselspital, University Hospital Bern, Bern, Switzerland; Feinberg School of Medicine, Northwestern University Chicago, Chicago, Illinois. Electronic address: marion_munk@hotmail.com.
² Gutblick Practice Group, Pfäffikon, Switzerland; Stadtspital Zürich, Zürich, Switzerland; Department of Ophthalmology, Semmelweis University, Budapest, Hungary.
³ Medical Retina Department, Moorfields Eye Hospital National Health Service Foundation Trust, London, United Kingdom; Vitreous Retina Macula Consultants New York, New York.
⁴ Department of Ophthalmology, Inselspital, University Hospital Bern, Bern, Switzerland.
⁵ Vitreous Retina Macula Consultants New York, New York; Department of Ophthalmology, New York University Grossman School of Medicine, New York, New York.
⁶ Doheny Eye Institute, Pasadena, California; University of California - Los Angeles, Los Angeles, California.
⁷ Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom.
⁸ Department of Bioengineering, University of Washington, Seattle, Washington; Department of Ophthalmology, University of Washington, Seattle, Washington.
⁹ Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria.
¹⁰ Department of Ophthalmology and Visual Sciences, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, Alabama.
¹¹ Joslin Diabetes Center, Beetham Eye Institute, Harvard Department of Ophthalmology, Boston, Massachusetts.
¹² Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland.
¹³ Department of Ophthalmology & Visual Sciences, Medical College of Wisconsin, Milwaukee, WI, United States.
¹⁴ South Carolina Retina Institute, Conway, South Carolina.
¹⁵ Sue Anschutz-Rodgers Eye Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
¹⁶ Ophthalmology Department, Hopital Nord, Aix Marseille University, Marseille, France.
¹⁷ Westmead and Central (Save Sight Institute) Clinical Schools, Specialty of Clinical Ophthalmology and Eye Health, University of Sydney, Sydney, Australia; Department of Ophthalmology, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia; Department of Ophthalmology, Westmead Hospital, Sydney, New South Wales, Australia.
¹⁸ Department of Surgical Sciences, University of Turin, Turin, Italy; Department of Ophthalmology, "City of Health and Science" Hospital, Turin, Italy.
¹⁹ Shri Bhagwan Mahavir Vitreoretinal Services, Medical Research Foundation, Chennai, Tamil Nadu, India.
²⁰ UniSR - IRCCS San Raffaele Scientific Institute, Milan, Italy.
²¹ Radboud University Medical Center (Radboudumc), Dept. of Ophthalmology, Nijmegen, the Netherlands.
²² Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, Tamil Nadu, India.
²³ The Eye Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates; Cleveland Clinic Lerner College of Medicine, Cleveland, OH, USA.
²⁴ School of Medicine, Vita-Salute San Raffaele University, Milan, Italy; Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy.
²⁵ East Bay Retina Consultants, Inc. Department of Ophthalmology, University of California San Francisco, USA.
²⁶ Universidad de Costa Rica, Caja Costarricense del Seguro Social, Hospital Clinica Biblica, Costa Rica.
²⁷ Centre of Ophthalmology and Visual Science (incorporating Lions Eye Institute), The University of Western Australia, Western Australia, Australia; Ophthalmology, Department of Surgery, University of Melbourne, East Melbourne, Victoria, Australia; Department of Ophthalmology, Royal Perth Hospital, Perth, Western Australia, Australia; Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia.
²⁸ Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy.
²⁹ Johns Hopkins University, Wilmer Eye Institute, Baltimore, MD, USA.
³⁰ Université Paris Cité, Hopital Lariboisière APHP, Centre d'Imagerie et Laser, Paris, France.
³¹ Byers Eye Institute of Stanford University, USA.
³² John A. Moran Eye Center, University of Utah, USA; Department of Ophthalmology, University of Bonn, Germany.
³³ Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, USA.
³⁴ Partner Retina Vitreous Associates, USA; Adjunct Clinical Professor of Ophthalmology, University of Southern California/Keck School of Medicine, USA.
³⁵ Singapore National Eye Center, Singapore.
³⁶ Wisconsin Reading Center, University of Wisconsin, Madison, USA.
³⁷ Department of Ophthalmology, Kindai University Faculty of Medicine, Japan.
³⁸ NIHR Moorfields Biomedical Research Centre, Moorfields Eye Hospital, London, UK; Ophthalmology Department, Tanta University, Egypt.
³⁹ Professor of Ophthalmology, Tanta University, Egypt.
⁴⁰ Ophthalmology Unit, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena University Hospital, Siena, Italy.
⁴¹ Fundonal, Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogota, DC, Colombia.
⁴² Moorfields Eye Hospital NHS Foundation Trust, London, UK; Department of Ophthalmology and Optometry, Kepler University Hospital, Johannes Kepler University, Linz, Austria.
⁴³ University Paris Est Creteil, France.
⁴⁴ UCLA Stein Eye Institute, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
⁴⁵ University of Bonn, Germany.
⁴⁶ Pusan National University Hospital, Pusan National University School of Medicine, South Korea.
⁴⁷ University Hospital Bonn, Department of Ophthalmology, Germany.
⁴⁸ Department of Ophthalmology, University Hospital Bern, Switzerland.
⁴⁹ Department of Ophthalmology, University of Paris Cité, Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris, France.
⁵⁰ Eye Research Center, The Five Senses Health Institute, Iran University of Medical Sciences, Iran.
⁵¹ National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore.
⁵² NIHR Moorfields Biomedical Research Centre, Moorfields Eye Hospital, London, UK.
⁵³ Ophthalmology Unit, Department of Medicine, Surgery and Neurosciences, University of Siena and Azienda Ospedaliero-Universitaria Senese (European Reference Network [ERN] for Rare Immunodeficiency, Autoinflammatory, and Autoimmune Diseases [RITA] Center), Policlinico "Le Scotte," viale Bracci 16, 53100 Siena, Italy.
⁵⁴ Policlinico Universitario Agostino Gemelli, Rome, Italy.
⁵⁵ A.O.R.N. dei Colli - Monaldi Hospital, Napoli, Italy.

PMID: 39894444
DOI: 10.1016/j.oret.2025.01.015

Abstract

Objective: To develop a consensus nomenclature for OCT angiography (OCTA) findings in retinal vascular diseases (RVDs).

Design: Expert consensus using standardized online surveys with modified Likert scale.

Participants: Retinal vascular disease imaging experts, OCT biomedical engineers, and the members of the International Retinal Imaging Society (IntRIS) METHODS: A PubMed literature review identified quantitative and qualitative terms forming the basis for a consensus-building process using a modified Delphi method. Agreement levels were categorized as "Accepted" (median ≥6), "Considerable Consensus" (median, 6-7; interquartile range [IQR] ≤3), "Strong Consensus" (median ≥8; IQR ≤2), and "Refined Strong Consensus" (median ≥8, IQR ≤2, with ≥70% of responses in the 8-10 range). A multidisciplinary expert panel refined the terminology through 3 survey rounds, leading to a final survey conducted by IntRIS members.

Main outcome measures: Consensus on OCTA nomenclature in RVD.

Results: The literature review identified 58 relevant papers, yielding 51 quantitative and 108 qualitative terms. A series of 3 surveys was used to refine the nomenclature framework for describing OCTA findings. The selected framework includes a generic term ("OCTA signal"), adjective terms ("presence/absence," "decreased/increased," "normal/abnormal"), and descriptive/etiologic terms ("of unknown cause," "due to blockage," "due to non-perfusion"). In the final survey among 44 IntRIS members, the framework achieved strong consensus for overall acceptance (median, 8.0; IQR, 7.0-9.0). The term "OCTA signal" met refined strong consensus criteria (median, 8.0; IQR, 8.0-9.0, with ≥70% of responses in the 8-10 range). Adjective terms, including "absence/presence" and "increased/decreased," were also rated with strong consensus (median, 8.0; IQR, 7.0-9.0). Similarly, descriptive/etiologic terms achieved strong consensus (median, 8.0; IQR, 7.0-9.0). Adoption of the framework for clinical practice and scientific reporting was rated with strong consensus (clinical: median, 8.0; IQR, 7.0-9.0; scientific: median, 9.0; IQR, 8.5-10.0).

Conclusions: This study establishes a strong consensus framework for reporting OCTA findings in RVD for clinical and scientific contexts.

Financial disclosure(s): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

Keywords: International Retina Imaging Society; Nomenclature; OCT angiography; Retinal vascular diseases; Standardization.

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Standardization of OCT Angiography Nomenclature in Retinal Vascular Diseases: Consensus-Based Recommendations

Collaborators

Affiliations

Standardization of OCT Angiography Nomenclature in Retinal Vascular Diseases: Consensus-Based Recommendations

Authors

Collaborators

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Abstract

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LinkOut - more resources

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Medical

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