Standardization of OCT Angiography Nomenclature in Retinal Vascular Diseases

Objective: To develop a consensus nomenclature for OCT angiography (OCTA) findings in retinal vascular diseases (RVDs). Design: Expert consensus using standardized online surveys with modified Likert scale. Participants: Retinal vascular disease imaging experts, OCT biomedical engineers, and the members of the International Retinal Imaging Society (IntRIS) Methods: A PubMed literature review identified quantitative and qualitative terms forming the basis for a consensus-building process using a modified Delphi method. Agreement levels were categorized as “Accepted” (median ≥6), “Considerable Consensus” (median, 6–7; interquartile range [IQR] ≤3), “Strong Consensus” (median ≥8; IQR ≤2), and “Refined Strong Consensus” (median ≥8, IQR ≤2, with ≥70% of responses in the 8–10 range). A multidisciplinary expert panel refined the terminology through 3 survey rounds, leading to a final survey conducted by IntRIS members. Main Outcome Measures: Consensus on OCTA nomenclature in RVD. Results: The literature review identified 58 relevant papers, yielding 51 quantitative and 108 qualitative terms. A series of 3 surveys was used to refine the nomenclature framework for describing OCTA findings. The selected framework includes a generic term (“OCTA signal”), adjective terms (“presence/absence,” “decreased/increased,” “normal/abnormal”), and descriptive/etiologic terms (“of unknown cause,” “due to blockage,” “due to non-perfusion”). In the final survey among 44 IntRIS members, the framework achieved strong consensus for overall acceptance (median, 8.0; IQR, 7.0–9.0). The term “OCTA signal” met refined strong consensus criteria (median, 8.0; IQR, 8.0–9.0, with ≥70% of responses in the 8–10 range). Adjective terms, including “absence/presence” and “increased/decreased,” were also rated with strong consensus (median, 8.0; IQR, 7.0–9.0). Similarly, descriptive/etiologic terms achieved strong consensus (median, 8.0; IQR, 7.0–9.0). Adoption of the framework for clinical practice and scientific reporting was rated with strong consensus (clinical: median, 8.0; IQR, 7.0–9.0; scientific: median, 9.0; IQR, 8.5–10.0). Conclusions: This study establishes a strong consensus framework for reporting OCTA findings in RVD for clinical and scientific contexts. Financial Disclosure(s): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.