Fig. 2

OCTA Interpretation Toolkit. How to apply step-by-step OCTA interpretation toolkit in a patient with AMD. Step 1: Image the right spot. Color fundus photograph of a patient with known AMD, the macula was selected as the area of interest and imaged. Step 2: Look at the en face OCTA images. 3 × 3 mm en face projections of each the full retinal depth, the avascular slab and the choriocapillaris (from left to right). The avascular and choriocapillaris slabs should be assessed in this AMD patient to check for presence of MNV. Note clearly defined vascular structures in the choriocapillaris slab (right most image), this is concerning for a type 1 MNV. Step 3: Look at the segmentation lines. Segmentation is assessed at multiple points throughout the slab to ensure accuracy. Step 4: Look at the B-scan with flow overlay. B-scan through lesion shows clear flow below the RPE (white arrow) and no projection artifact from overlying vasculature, suggesting this is in fact an MNV. Step 5: Look at the en face intensity image. En face intensity image for the choriocapillaris slab shows strong signal, shadowing artifact is not expected to disrupt image interpretation. Summary: Methodical OCTA image analysis uncovered a type 1 MNV that was not visible on fundus examination or on full depth retinal projection