Researchers from the Shiley Eye Institute, University of California, San Diego, had 4 expert reviewers evaluate 5,263 OCTA images of normal, glaucoma-suspect, and glaucomatous eyes to determine the percentage of those with a variety of OCTA artifacts that could interfere with correct treatment decisions. Overall, 33.9% of the OCTA images had poor quality. The majority of images with acceptable quality scores had no artifacts (76.6%). Other images had 1 (13.6%) or 2 or more artifacts (9.8%). Older age, male gender, worse visual field mean deviation, absence of eye tracking, and macular scan area were associated with a greater likelihood of obtaining poor quality images.

The researchers concluded that OCTA artifacts associated with poor-quality images are frequent, their prevalence is affected by ocular and patient characteristics, and clinicians should not rely solely on the quantitative assessments provided automatically by OCTA instruments. A systematic scan review should be conducted to ensure appropriate interpretation of OCTA images. Given the high prevalence of poor-quality OCTA images, the images should be reacquired whenever an apparent and correctable artifact is present on a captured image. The findings were published in the journal Ophthalmology.