Comparison of wide field optical coherence tomography angiography with extended field imaging and fluorescein angiography in retinal vascular disorders

Purpose To compare swept source OCTA device, with and without the extended field imaging (EFI) technique, to standard fluorescein angiography (FA) in the clinical practice. Methods Consecutive patients with vascular disorder patients underwent FA with 55-degree lens (Spectralis Heidelberg Engineering, Heidelberg, Germany) and OCTA with the prototype PlexElite (Carl Zeiss Meditec, Dublin, CA) using a 12 mm x 12 mm volume scan pattern centered on the fovea and a prototype of + 20.00-diopter designed specifically by Zeiss. The imaging methods were compared for visible field of view, extension of non-perfused areas, presence and number of neovessels, vessel density (VD) and fractal dimension (FD). Results Forty-three eyes of 27 patients were included. The mean extension ratio of EFI SS-OCTA compared to SS-OCTA without EFI and FA were 1.97 ± 0.02 and 0.85 ± 0.01. The mean extension of non-perfused areas with EFI SS-OCTA (34.22 ± 33.4 mm 2 ) was significantly higher than SS-OCTA without EFI (20.46 ± 18.70 mm 2 ), and with FA (27.55 ± 4.4 mm 2 ). The mean VD and FD of EFI SS-OCTA were significantly different compared to SS-OCT without EFI. Conclusions EFI SS-OCTA captured larger areas than SS-OCTA without EFI and FA. OCTA in a single shot is able to obtain more information of the retina without the use of montage techniques. Despite the determination of retinal ischemia seems to be easier and more accurate using EFI SS-OCTA, FA offers more details of the perfusion status of the retina.