Image Artifacts in Optical Coherence Tomography Angiography Among Patients With Multiple Sclerosis

Mustafa Iftikhar, Sidra Zafar, Natalia Gonzalez, Olwen Murphy, M. S. Ohemaa Kwakyi, B. S. Sydney Feldman, Peter A. Calabresi, Shiv Saidha, Roomasa Channa

Research output: Contribution to journalArticlepeer-review


Purpose: To evaluate artifacts in optical coherence tomography angiography (OCT-A) images of multiple sclerosis (MS) patients and healthy controls. Materials and methods: This was a prospective cross-sectional study conducted at the Department of Neurology and the Wilmer Eye Institute at Johns Hopkins Hospital. Subjects included patients with an established diagnosis of MS and healthy volunteers. OCT-A was performed using Spectralis® OCT-A prototype, OCT2 (Heidelberg, Germany). The type and frequency of artifacts, the clinical factors associated with them, and their impact on vessel density measurements were assessed. Results: Overall, 385 images from 102 participants were analyzed. The majority of images (97.1%) had some degree of artifact. The most frequent was motion artifact (96.3%), followed by blinking (51.9%), and loss of focus (25.1%). MS patients were more likely to have any artifact vs. controls (OR [95% CI], 3.83 [1.12–12.92]), and were more likely to have motion artifacts with longer disease duration (OR [95% CI], 1.11 [1.03–1.20]) or history of optic neuritis (OR [95% CI], 4.24 [1.19–15.16]). The relative area occupied by the artifact was found to underestimate vessel density measurements in both MS patients and controls. Conclusions: Artifacts are common with OCT-A imaging using this particular Spectralis® OCT-A prototype and can impact quantitative vascular density metrics. Future studies should review images for artifacts before drawing definitive conclusions.

Original languageEnglish (US)
Pages (from-to)558-563
Number of pages6
JournalCurrent Eye Research
Issue number5
StatePublished - May 4 2019


  • Image Artifacts
  • Image Quality
  • Multiple Sclerosis
  • Optical Coherence Tomography Angiography

ASJC Scopus subject areas

  • Ophthalmology
  • Sensory Systems
  • Cellular and Molecular Neuroscience


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