Optical coherence tomography angiography (OCTA) 4.5×4.5 mm images of the peripapillary vessels demonstrated strong repeatability and reproducibility in both non glaucomatous and glaucomatous eyes, with commercially provided OCTA parameters demonstrating superior reliability to custom OCTA parameters. The goal of this study was to compare the reproducibility of peripapillary vascular characteristics from 4.5×4.5 mm OCTA scans performed on non glaucomatous eyes to that of glaucomatous eyes, both intralesionally and between sessions. In a long-term study, researchers used specialized quantification software to calculate vessel area density (VAD) and determine the perfusion density (PD) and flux index (FI) from a series of peripapillary OCTA scans, whereas clinicians used commercially created software (Cirrus 11.0.0) to analyze the scans. The within-eye coefficient of variation (CVw) and the intraclass correlation coefficient (ICC) were used to assess the level of consistency from one testing session to the next and between several testing sessions. There were 127 eyes tested for glaucoma, and the intrasession CVw for vessel area density (VAD), PD, flux, and FI were 1.90%, 1.17%, 2.787, and 1.425, respectively. CVw ranged from 2.039% to 1.606.6%, 4.053% to 2.798.0% between sessions. The average intrasession ICC was 0.956, while the average inter-session ICC was 0.896. The intrasession CVw for VAD, PD, flux, and FI in a sample of 144 glaucomatous eyes were 3.841%, 1.493%, 5.009%, and 2.4321%, respectively. During the intervals between sessions, the CVw was 4.991%, 2.15%, 6.36%, and 3.458%. The average intra-session ICC was 0.969, with the inter-session ICC falling in the range of 0.918–0.964. Most peripapillary OCTA vascular characteristics from 4.5×4.5 mm images demonstrated higher intrasession repeatability than intersession reproducibility across both glaucomatous and nonglaucomatous eyes. The commercially created quantification parameters had higher levels of agreement than the bespoke quantification parameters.
