**4. Limitations of optical coherence tomography angiography**

Image artifacts are frequently encountered in OCTA and can hinder the interpretability of the microvascular structure and VD. In addition, media opacities and pupillary size can similarly affect the quality of OCTA maps and the calculation of VDs. Optimizing interscan time can also present a challenge in OCTA. While short capture times cannot detect slow flow velocities such as those observed in cases of venous occlusions [45], long interscan times are more sensitive to motion artifacts. Lastly, the lack of standardization across different devices and protocols remains a lingering limitation. For example, different commercially available OCTA devices differ in their methods of segmentation of the angiography slabs and axial and lateral resolutions [46].
