{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T09:24:33Z","timestamp":1787217873304,"version":"build-2736575974"},"reference-count":56,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T00:00:00Z","timestamp":1787184000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Med. Sci.","Medical Sciences"],"abstract":"<jats:p>Background: Optical coherence tomography angiography (OCTA) provides quantitative metrics of the retinal microvasculature, most prominently vessel density (VD), that are increasingly used as biomarkers in ocular, systemic, and cerebrovascular disease. Because OCTA relies on the detection of flow-related motion contrast, image quality has emerged as a pervasive determinant of these metrics, yet its effect has been reported in fragmentary and non-comparable ways across the literature. Methods: We identified OCTA studies indexed in PubMed that examined the relationship between image quality and quantitative OCTA parameters, and we summarised their methods and findings across the macular, foveal avascular zone, and peripapillary regions and across vascular layers. We integrated directly comparable per-unit scan-quality effects using random-effects meta-analysis and separately synthesized direct cross-sectional Pearson correlations between manufacturer-reported image quality and macular vessel-density outcomes from independent healthy cohorts. Results: Higher image quality was associated with higher measured vessel density in every contributing dataset. On the Optovue scan-quality (SQ, 0\u201310) scale, superficial macular VD increased by 3.46% (95% CI 1.85\u20135.07) per SQ unit in controlled signal-attenuation experiments and by covariate-adjusted observational estimates ranging from 0.90% to 2.16% per SQ unit; a combined order-of-magnitude estimate across both estimator types was 1.64% (95% CI 1.15\u20132.12). Peripapillary estimates were heterogeneous and derived from only two independent cohorts; they were therefore summarised descriptively rather than pooled. Across three independent externally authored healthy cohorts reporting direct cross-sectional Pearson correlations, higher image quality was strongly associated with higher macular vessel-density outcomes (random-effects pooled r = 0.64, 95% CI 0.50\u20130.75; I2 = 49%). Conclusions: Image quality is an important, directional confounder of VD-based OCTA metrics whose magnitude can rival the biological or physiological signal of interest. Platform-appropriate standardisation, transparent reporting, and consideration of image quality in acquisition and analysis are therefore important for the valid interpretation of vessel-density measurements, particularly in functional and longitudinal studies.<\/jats:p>","DOI":"10.3390\/medsci14040498","type":"journal-article","created":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T08:10:20Z","timestamp":1787213420000},"page":"498","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Image Quality as an Important Confounder in Quantitative OCT Angiography: A Review with Quantitative Synthesis"],"prefix":"10.3390","volume":"14","author":[{"given":"Lilla","family":"Istv\u00e1n","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Semmelweis University, H-1085 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecilia","family":"Czak\u00f3","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Semmelweis University, H-1085 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R\u00f3bert","family":"Debreczeni","sequence":"additional","affiliation":[{"name":"Department of Neurology, Semmelweis University, H-1085 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P\u00e9ter","family":"S\u00f3tonyi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Semmelweis University, H-1085 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e1s","family":"Horv\u00e1th","sequence":"additional","affiliation":[{"name":"Neurocognitive Research Center, Ny\u00edr\u0151 Gyula National Institute of Psychiatry, and Addictology, H-1145 Budapest, Hungary"},{"name":"Department of Anatomy, Histology and Embryology, Semmelweis University, H-1094 Budapest, Hungary"},{"name":"Faculty of Medicine, Universidade de Lisboa, 1649-028 Lisbon, Portugal"},{"name":"Institute of Cognitive Neuroscience and Psychology, Research Centre for Natural Sciences, Hungarian Research Network, H-1117 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N\u00f3ra","family":"Szentm\u00e1ry","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Semmelweis University, H-1085 Budapest, Hungary"},{"name":"Experimental Ophthalmology, Saarland University, 66424 Homburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zolt\u00e1n Zsolt","family":"Nagy","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Semmelweis University, H-1085 Budapest, Hungary"},{"name":"Department of Clinical Ophthalmology, Faculty of Health Sciences, Semmelweis University, H-1085 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ill\u00e9s","family":"Kov\u00e1cs","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Semmelweis University, H-1085 Budapest, Hungary"},{"name":"Department of Clinical Ophthalmology, Faculty of Health Sciences, Semmelweis University, H-1085 Budapest, Hungary"},{"name":"Department of Ophthalmology, Weill Cornell Medicine, New York, NY 10021, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1038\/s41377-022-00740-9","article-title":"Towards standardizing retinal optical coherence tomography angiography: A review","volume":"11","author":"Sampson","year":"2022","journal-title":"Light Sci. Appl."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Enders, C., Lang, G.E., Dreyhaupt, J., Loidl, M., Lang, G.K., and Werner, J.U. (2019). Quantity and quality of image artifacts in optical coherence tomography angiography. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0210505"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e200169","DOI":"10.1212\/NXI.0000000000200169","article-title":"The OSCAR-MP consensus criteria for quality assessment of retinal optical coherence tomography angiography","volume":"10","author":"Wicklein","year":"2023","journal-title":"Neurol. Neuroimmunol. Neuroinflamm."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1007\/s11357-021-00492-1","article-title":"The effect of systemic factors on retinal blood flow in patients with carotid stenosis: An optical coherence tomography angiography study","volume":"44","author":"Istvan","year":"2022","journal-title":"GeroScience"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Mihaly, Z., Istvan, L., Czako, C., Benyo, F., Borzsak, S., Varga, A., Magyar-Stang, R., Banga, P.V., Elo, A., and Debreczeni, R. (2023). The effect of circle of Willis morphology on retinal blood flow in patients with carotid stenosis measured by optical coherence tomography angiography. J. Clin. Med., 12.","DOI":"10.3390\/jcm12165335"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Czako, C., Gerencser, D., Kormanyos, K., Keki-Kovacs, K., Nemeth, O., Toth, G., Sandor, G.L., Csorba, A., Langenbucher, A., and Nagy, Z.Z. (2023). Evaluation of retinal blood flow in patients with monoclonal gammopathy using OCT angiography. J. Clin. Med., 12.","DOI":"10.3390\/jcm12165227"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Magyar-Stang, R., Istvan, L., Pal, H., Csanyi, B., Gaal, A., Mihaly, Z., Czinege, Z., Sotonyi, P., Tamas, H., and Koller, A. (2023). Impaired cerebrovascular reactivity correlates with reduced retinal vessel density in patients with carotid artery stenosis: An optical coherence tomography angiography study. PLoS ONE, 18.","DOI":"10.1371\/journal.pone.0291521"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"12897","DOI":"10.1038\/s41598-018-31321-9","article-title":"The importance of signal strength in quantitative assessment of retinal vessel density using optical coherence tomography angiography","volume":"8","author":"Lim","year":"2018","journal-title":"Sci. Rep."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1186\/s40942-019-0197-4","article-title":"The effect of image quality on the reliability of OCT angiography measurements in patients with diabetes","volume":"5","author":"Czako","year":"2019","journal-title":"Int. J. Retin. Vitr."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"16299","DOI":"10.1038\/s41598-019-52818-x","article-title":"Signal strength as an important factor in the analysis of peripapillary microvascular density using optical coherence tomography angiography","volume":"9","author":"Lim","year":"2019","journal-title":"Sci. Rep."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1016\/j.oret.2019.04.029","article-title":"Signal strength reduction effects in OCT angiography","volume":"3","author":"Yu","year":"2019","journal-title":"Ophthalmol. Retin."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"4692","DOI":"10.1038\/s41598-022-08781-1","article-title":"Impact of signal strength on quantitative retinal and choriocapillaris flow measurement from optical coherence tomography angiography","volume":"12","author":"Lee","year":"2022","journal-title":"Sci. Rep."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1167\/tvst.9.5.10","article-title":"The impact of deterministic signal loss on OCT angiography measurements","volume":"9","author":"Czako","year":"2020","journal-title":"Transl. Vis. Sci. Technol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1167\/tvst.13.8.43","article-title":"High prevalence of artifacts in optical coherence tomography angiography with adequate signal strength","volume":"13","author":"Lin","year":"2024","journal-title":"Transl. Vis. Sci. Technol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"3481","DOI":"10.2147\/OPTH.S378722","article-title":"The importance of signal strength index in optical coherence tomography angiography: A study in eyes with pseudoexfoliation syndrome","volume":"16","author":"Pradhan","year":"2022","journal-title":"Clin. Ophthalmol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"10598","DOI":"10.1038\/s41598-018-28994-7","article-title":"Intrasession and between-visit variability of retinal vessel density values measured with OCT angiography in diabetic patients","volume":"8","author":"Czako","year":"2018","journal-title":"Sci. Rep."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"\u00c9l\u0151, \u00c1., Istv\u00e1n, L., Horv\u00e1th, A.A., Horv\u00e1th, K., \u00d3dor, T., Andorfi, T., Nagy, Z.Z., and Kov\u00e1cs, I. (2026). Detection of Retinal Neurovascular Coupling During Light Adaptation Using Optical Coherence Tomography Angiography: A Pilot Study. Life, 16.","DOI":"10.3390\/life16071109"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"13775","DOI":"10.1038\/s41598-022-17709-8","article-title":"Deep learning for quality assessment of optical coherence tomography angiography images","volume":"12","author":"Dhodapkar","year":"2022","journal-title":"Sci. Rep."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1167\/tvst.12.6.30","article-title":"Convolutional neural network-based automated quality assessment of OCT and OCT angiography image maps in individuals with neurodegenerative disease","volume":"12","author":"Lee","year":"2023","journal-title":"Transl. Vis. Sci. Technol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1186\/s40942-017-0068-9","article-title":"Impact of image quality on OCT angiography based quantitative measurements","volume":"3","author":"Akil","year":"2017","journal-title":"Int. J. Retin. Vitr."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"23832","DOI":"10.1038\/s41598-021-03469-4","article-title":"Long-term repeatability of peripapillary optical coherence tomography angiography measurements in healthy eyes","volume":"11","author":"Lee","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1167\/tvst.10.3.2","article-title":"Optical coherence tomography angiography quality across three multicenter clinical studies of diabetic retinopathy","volume":"10","author":"Lujan","year":"2021","journal-title":"Transl. Vis. Sci. Technol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"13990","DOI":"10.1038\/s41598-024-61551-z","article-title":"Effect of manual OCTA segmentation correction to improve image quality and visibility of choroidal neovascularization in AMD","volume":"14","author":"Deussen","year":"2024","journal-title":"Sci. Rep."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"786","DOI":"10.1097\/IAE.0000000000002453","article-title":"Correlation of en face optical coherence tomography angiography averaging versus single-image quantitative measurements with retinal vein occlusion","volume":"40","author":"Jung","year":"2020","journal-title":"Retina"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1186\/s40942-025-00653-w","article-title":"\u201cSetting the standard\u201d: An analysis of different acquisition patterns for macular optical coherence tomography angiography","volume":"11","author":"Gujar","year":"2025","journal-title":"Int. J. Retin. Vitr."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1589","DOI":"10.1016\/j.ophtha.2017.06.002","article-title":"Projection-Resolved Optical Coherence Tomography Angiography of Macular Retinal Circulation in Glaucoma","volume":"124","author":"Takusagawa","year":"2017","journal-title":"Ophthalmology"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1136\/bjophthalmol-2020-318646","article-title":"Deep Learning-Based Signal-Independent Assessment of Macular Avascular Area on 6\u00d76-mm OCTA in Diabetic Retinopathy: A Comparison to Instrument-Embedded Software","volume":"107","author":"Xiong","year":"2023","journal-title":"Br. J. Ophthalmol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.preteyeres.2017.11.003","article-title":"Optical coherence tomography angiography","volume":"64","author":"Spaide","year":"2018","journal-title":"Prog. Retin. Eye Res."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1016\/j.preteyeres.2017.07.002","article-title":"Optical coherence tomography angiography: A comprehensive review of current methods and clinical applications","volume":"60","author":"Kashani","year":"2017","journal-title":"Prog. Retin. Eye Res."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"5502","DOI":"10.1167\/iovs.12-10265","article-title":"Quantitative morphometry of perifoveal capillary networks in the human retina","volume":"53","author":"Chan","year":"2012","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"4327","DOI":"10.1167\/iovs.18-24105","article-title":"Three-Dimensional Microscopy Demonstrates Series and Parallel Organization of Human Peripapillary Capillary Plexuses","volume":"59","author":"Chandrasekera","year":"2018","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"3065","DOI":"10.1167\/iovs.17-21551","article-title":"Axial Length Variation Impacts on Superficial Retinal Vessel Density and Foveal Avascular Zone Area Measurements Using Optical Coherence Tomography Angiography","volume":"58","author":"Sampson","year":"2017","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1322","DOI":"10.1016\/j.ophtha.2014.01.021","article-title":"Optical coherence tomography angiography of optic disc perfusion in glaucoma","volume":"121","author":"Jia","year":"2014","journal-title":"Ophthalmology"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1045","DOI":"10.1001\/jamaophthalmol.2015.2225","article-title":"Optical Coherence Tomography Angiography of the Peripapillary Retina in Glaucoma","volume":"133","author":"Liu","year":"2015","journal-title":"JAMA Ophthalmol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"5780","DOI":"10.1167\/iovs.16-20045","article-title":"Retinal Capillary Density and Foveal Avascular Zone Area Are Age-Dependent: Quantitative Analysis Using Optical Coherence Tomography Angiography","volume":"57","author":"Iafe","year":"2016","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1347","DOI":"10.1016\/j.ophtha.2007.11.027","article-title":"Relationship between retinal nerve fiber layer measurement and signal strength in optical coherence tomography","volume":"115","author":"Cheung","year":"2008","journal-title":"Ophthalmology"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1167\/tvst.4.5.7","article-title":"Effect of Signal Intensity on Measurement of Ganglion Cell Complex and Retinal Nerve Fiber Layer Scans in Fourier-Domain Optical Coherence Tomography","volume":"4","author":"Zhang","year":"2015","journal-title":"Transl. Vis. Sci. Technol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"3810","DOI":"10.1167\/iovs.15-16502","article-title":"Histogram Matching Extends Acceptable Signal Strength Range on Optical Coherence Tomography Images","volume":"56","author":"Chen","year":"2015","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"949","DOI":"10.1136\/bjophthalmol-2018-312401","article-title":"Repeatability and comparability of peripapillary vessel density measurements of high-density and non-high-density optical coherence tomography angiography scans in normal and glaucoma eyes","volume":"103","author":"Venugopal","year":"2019","journal-title":"Br. J. Ophthalmol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1038\/eye.2017.181","article-title":"An overview of the clinical applications of optical coherence tomography angiography","volume":"32","author":"Tan","year":"2018","journal-title":"Eye"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"100951","DOI":"10.1016\/j.preteyeres.2021.100951","article-title":"Retinal applications of swept source optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA)","volume":"84","author":"Lains","year":"2021","journal-title":"Prog. Retin. Eye Res."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1167\/tvst.9.2.6","article-title":"Insights into Systemic Disease through Retinal Imaging-Based Oculomics","volume":"9","author":"Wagner","year":"2020","journal-title":"Transl. Vis. Sci. Technol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1532","DOI":"10.1364\/BOE.10.001532","article-title":"Retinal and choroidal vascular changes in coronary heart disease: An optical coherence tomography angiography study","volume":"10","author":"Wang","year":"2019","journal-title":"Biomed. Opt. Express"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"493","DOI":"10.3233\/JAD-201516","article-title":"The Contribution of Ocular Biomarkers in the Differential Diagnosis of Alzheimer\u2019s Disease versus Other Types of Dementia and Future Prospects","volume":"80","author":"Chalkias","year":"2021","journal-title":"J. Alzheimers Dis."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"981","DOI":"10.1016\/j.oret.2020.12.022","article-title":"Standardization of OCT Angiography Nomenclature in Retinal Vascular Diseases: First Survey Results","volume":"5","author":"Munk","year":"2021","journal-title":"Ophthalmol. Retin."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1109","DOI":"10.1016\/j.ophtha.2020.12.022","article-title":"Deliberations of an International Panel of Experts on OCT Angiography Nomenclature of Neovascular Age-Related Macular Degeneration","volume":"128","author":"Mendonca","year":"2021","journal-title":"Ophthalmology"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"871","DOI":"10.1159\/000518620","article-title":"Standardization of Optical Coherence Tomography Angiography Imaging Biomarkers in Diabetic Retinal Disease","volume":"64","author":"Vujosevic","year":"2021","journal-title":"Ophthalmic Res."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1001\/jamaophthalmol.2019.4971","article-title":"Prevalence and Severity of Artifacts in Optical Coherence Tomographic Angiograms","volume":"138","author":"Holmen","year":"2020","journal-title":"JAMA Ophthalmol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"2163","DOI":"10.1097\/IAE.0000000000000765","article-title":"Image artifacts in optical coherence tomography angiography","volume":"35","author":"Spaide","year":"2015","journal-title":"Retina"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1001\/jamaophthalmol.2017.0080","article-title":"Quantification of Retinal Microvascular Density in Optical Coherence Tomographic Angiography Images in Diabetic Retinopathy","volume":"135","author":"Durbin","year":"2017","journal-title":"JAMA Ophthalmol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1535","DOI":"10.1007\/s00417-017-3684-z","article-title":"Impact of eye-tracking technology on OCT-angiography imaging quality in age-related macular degeneration","volume":"255","author":"Lauermann","year":"2017","journal-title":"Graefes Arch. Clin. Exp. Ophthalmol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"2830","DOI":"10.1364\/BOE.392759","article-title":"Correction propagation for user-assisted optical coherence tomography segmentation: General framework and application to Bruch\u2019s membrane segmentation","volume":"11","author":"Stromer","year":"2020","journal-title":"Biomed. Opt. Express"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1016\/j.jcjo.2019.12.007","article-title":"Segmentation errors and motion artifacts in OCT-A associated with epiretinal membranes","volume":"55","author":"Bontzos","year":"2020","journal-title":"Can. J. Ophthalmol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1807","DOI":"10.1007\/s00417-018-4053-2","article-title":"Prevalences of segmentation errors and motion artifacts in OCT-angiography differ among retinal diseases","volume":"256","author":"Lauermann","year":"2018","journal-title":"Graefes Arch. Clin. Exp. Ophthalmol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1016\/j.oret.2017.01.019","article-title":"The Definition, Rationale, and Effects of Thresholding in OCT Angiography","volume":"1","author":"Cole","year":"2017","journal-title":"Ophthalmol. Retin."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1641","DOI":"10.1007\/s00417-019-04338-7","article-title":"Automated OCT angiography image quality assessment using a deep learning algorithm","volume":"257","author":"Lauermann","year":"2019","journal-title":"Graefes Arch. Clin. Exp. Ophthalmol."}],"container-title":["Medical Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-3271\/14\/4\/498\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T08:39:22Z","timestamp":1787215162000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-3271\/14\/4\/498"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,20]]},"references-count":56,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["medsci14040498"],"URL":"https:\/\/doi.org\/10.3390\/medsci14040498","relation":{},"ISSN":["2076-3271"],"issn-type":[{"value":"2076-3271","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,20]]}}}