Title: Quantitative Characterization of Retinal Features in Translated OCTA

Abstract: Purpose: This study explores the feasibility of using generative machine learning (ML) to translate Optical Coherence Tomography (OCT) images into Optical Coherence Tomography Angiography (OCTA) images, potentially bypassing the need for specialized OCTA hardware. Methods: The method involved implementing a generative adversarial network framework that includes a 2D vascular segmentation model and a 2D OCTA image translation model. The study utilizes a public dataset of 500 patients, divided into subsets based on resolution and disease status, to validate the quality of TR-OCTA images. The validation employs several quality and quantitative metrics to compare the translated images with ground truth OCTAs (GT-OCTA). We then quantitatively characterize vascular features generated in TR-OCTAs with GT-OCTAs to assess the feasibility of using TR-OCTA for objective disease diagnosis. Result: TR-OCTAs showed high image quality in both 3 and 6 mm datasets (high-resolution, moderate structural similarity and contrast quality compared to GT-OCTAs). There were slight discrepancies in vascular metrics, especially in diseased patients. Blood vessel features like tortuosity and vessel perimeter index showed a better trend compared to density features which are affected by local vascular distortions. Conclusion: This study presents a promising solution to the limitations of OCTA adoption in clinical practice by using vascular features from TR-OCTA for disease detection. Translation relevance: This study has the potential to significantly enhance the diagnostic process for retinal diseases by making detailed vascular imaging more widely available and reducing dependency on costly OCTA equipment.