Quality Control for Retinal Optical Coherence Tomography Angiography in Multiple Sclerosis: A Validation Study of the OSCAR-MP Criteria.

OBJECTIVES: Optical coherence tomography angiography (OCTA) is widely used for evaluating retinal vessels. The aim of this study was to assess the influence of OCTA quality, as measured by the previously introduced OSCAR-MP criteria, on OCTA outcome parameters and the reliability of test-retest results. METHODS: In this prospective longitudinal cohort study, we performed retinal OCTA at baseline and within 24 hours in 54 participants, including 42 healthy individuals and 12 patients with demyelinating CNS disease. We performed reliability testing on OCTA outcome parameters based on QC status according to the OSCAR-MP criteria. RESULTS: Retinal vessel density measurements remained consistent between baseline and follow-up scans when both passed quality control. By contrast, vessel densities were significantly higher in high-quality images than in paired lower quality ones. Reliability measures, such as intraclass correlation coefficient (ICC) and Pearson r, were higher in pairs where both images met quality standards, with a lower coefficient of repeatability and minimal detectable change observed. DISCUSSION: Poor OCTA image quality negatively affects retinal vessel density measurements. Implementing OSCAR-MP quality criteria demonstrated strong test-retest reliability in high-quality OCTA images, indicating its potential role as reliable quality criteria for OCTA in future clinical trials and research settings.