Validation of a novel automated algorithm to measure drusen volume and area using swept source optical coherence tomography angiography

Purpose: The purpose of this study was to validate a novel automated swept source optical coherence tomography angiography (SS-OCTA) algorithm to measure elevations of the retinal pigment epithelium (RPE) in eyes with nonexudative age-related macular degeneration (neAMD). Methods: Patients with drusen were enrolled in a prospective optical coherence tomography (OCT) study and underwent both spectral domain OCT (SD-OCT) and SS-OCTA imaging at the same visit using the 6 × 6 mm scan patterns. The RPE elevation measurements (square root area and cube root volume) from the SS-OCTA algorithm were compared with the automated validated SD-OCT algorithm on the instrument. Standard deviations of drusen measurements from four repeated scans of another separate set were also calculated to evaluate the reproducibility of the SS-OCTA algorithm. Results: A total of 53 eyes from 28 patients were scanned on both instruments. A very strong correlation was found between the measurements from the two algorithms (all r > 0.95), although the measurements of the drusen area and volume were all larger from the SS-OCTA instrument. The reproducibility of the new SS-OCTA algorithm was analyzed using a sample of 66 eyes from 43 patients. The intraclass correlation coefficient (ICC) was greater than 99% from different macular regions for both the square root area and cube root volume measurements. Conclusions: A novel automated SS-OCTA algorithm for the quantitative assessment of drusen was validated against the SD-OCT algorithm and was shown to be highly reproducible. Translational Relevance: This novel SS-OCTA algorithm provides a strategy to measure the area and volume of drusen to assess disease progression in neAMD.