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A Deep Dive Into OCTA

Experts discuss wet AMD, image interpretation, vascular imaging, new advances, and reimbursement.

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When we look back, it is hard to realize that it was only in 2016 that the first OCT angiography (OCTA) machine was approved by the FDA. Since then, OCTA has exploded into our consciousness, occupying ever-increasing space in the meetings we attend, the CMEs we get certified for, and in many of our clinical practices.

Partly, this is because the information that OCTA provides us is so detailed that it can be used for a multitude of purposes: research, diagnostics, therapeutic monitoring. Also, the information presented, while it may look familiar, is fundamentally different from what we see in dye-based angiography.

As a clinician, I think it is critically important to be able to hone in on exactly how this imaging modality will help with your clinical practice. How do we learn to use OCTA both expertly but also efficiently? What exactly is it that you need to look for in a diabetic patient or a patient with exudative AMD when you obtain an OCTA scan? The articles in this special section of Retinal Physiciandedicated to OCTA will try to address these clinically relevant questions.

Also, as many of you who have used OCTA in the clinic will know, interpretation of OCTA is not trivial. Looking through a dense data set of images may require at least as much time as looking through a set of flat photos that comprise fluorescein angiography. Additionally, the machines are expensive, and require training to use. While all of us want to do what is best and safest for our patients, buying OCTA machines and then integrating image acquisition and interpretation into our practices is clearly time consuming and expensive. And, at the present time, OCTA is not reimbursed. In the current reimbursement environment, and with the uncertainty that accompanies it, we need to think about how these expenses will be covered. In this OCTA section, we will touch upon this subject as well.

Mostly, this is just the beginning. We hope what you read here will be the start of a long conversation and a long process of exploring and learning that will continue long after you have put down these pages.

Happy reading!

— Nadia K. Waheed, MD, MPH

Editor's note: This special section of Retinal Physician was featured in episode 82 of "Straight From the Cutter's Mouth: A Retina Podcast."