Abstract
Early detection of neovascular age-related macular degeneration is vitally important so that treatment with vascular endothelial growth factor inhibitors can be initiated as soon as symptomatic exudation arises. Swept-source optical coherence tomography angiography (SS-OCTA) is an evolving imaging technology that combines the power of structural OCT imaging with the diagnostic impact of angiographic imaging without the use of any exogenous dyes. However, to properly use this leading-edge technology, clinicians must be properly trained. Unlike typical structural OCT scans in which both B-scans and en face images can be standardized for routine diagnostic use, the harvesting of angiographic information contained within the SS-OCTA scans requires an in depth appreciation of the segmentation strategies used to anatomically localize macular neovascularization (MNV) and an awareness of potential artifacts that can arise and confuse the interpretation of images. The key step in interpreting SS-OCTA images involves the selection of the most appropriate segmentation strategy for the detection of MNV. In general, a slab extending from the outer retina to the choriocapillaris, referred to as the ORCC slab, can be a useful first step when screening for all forms of MNV, and then more specific slabs can be used to better visualize the neovascular lesion.