The goal of this study was to compare the effects of fatigue on image quality and artifacts of Optical Coherence Tomography Angiography (OCTA).

In an interventional case series, for twenty nurses, OCTA was performed in two times; once early morning before duty shift and once after a twelve hours night shift. To compensate learning effect on cases cooperation, ten of the cases undergone OCTA first after night duty, and others vice versa. OCTA cube scans (3×3 mm) were acquired using the RTVue XR Avanti with AngioVue, Split-spectrum amplitude-decorrelation, and motion correction technology. Number of horizontal and vertical saccadic, blink, and stretch artifacts were recorded. Moreover, pain and discomfort based on subjective score was recorded as overall discomfort and discomfort experienced by blue focus light and red scanning laser.

All the cases were female nurses of ophthalmology department. Discomfort by blue light, red light and overall pain experience by the cases were more after the night shift (p values <0.001 in all measurements). Vertical saccadic (p-value: 0.037) and blink (p-value: 0.019) artifacts were different but horizontal saccadic artifact, stretch artifact and signal strength was not different.

Our study suggests that subjects fatigue may affect image quality of OCTA. As OCTA capturing needs more cooperation, it seems better to ask cases to participate when they are more spirited.