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The Diagnostic Accuracy of Optical Coherence Tomography Angiography for Neovascular Age-Related Macular Degeneration: A Comparison with Fundus Fluorescein Angiography.

Gong J, Yu S, Gong Y, Wang F, Sun X - J Ophthalmol (2016)

Bottom Line: Two independent readers calculated the sensitivity and specificity of OCTA in detecting CNV compared with FA.The specificity of OCTA for the detection of CNV was 67.6%, with sensitivity of 86.5%.OCTA may help in the noninvasive diagnosis of CNV and may provide a method for monitoring the evolution of CNV.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Shanghai General Hospital of Nanjing Medical University, Shanghai 200080, China; Department of Ophthalmology, Zhejiang Provincial People's Hospital, 158 Shangtang Road, Hangzhou, Zhejiang 310014, China.

ABSTRACT
Purpose. To describe the morphological characteristics and efficacy of OCTA in detecting CNV in nAMD. We retrospectively reviewed 53 patients (86 eyes) with suspected CNV secondary to wet AMD. All the patients underwent a multimodal assessment for CNV. Two independent readers calculated the sensitivity and specificity of OCTA in detecting CNV compared with FA. A qualitative analysis of OCTA was also performed to describe the morphological appearance of CNV. Among 86 eyes of 53 patients, 52 eyes were diagnosed as having CNV based on the FA imaging analysis. According to FA, CNV was classified as classic in 28 eyes, predominantly classic in 6 eyes, minimally classic in 9 eyes, and occult in 9 eyes. In 56 eyes, CNV was visualized on OCTA and corresponding OCT B-scans. In total, 46.4% (26/56) had well-circumscribed vessels, and 53.6% (30/56) showed poorly circumscribed vessels. There were 11 false positives and 7 false negatives using OCTA. The specificity of OCTA for the detection of CNV was 67.6%, with sensitivity of 86.5%. OCTA may help in the noninvasive diagnosis of CNV and may provide a method for monitoring the evolution of CNV.

No MeSH data available.


Related in: MedlinePlus

Distinguishing the choriocapillaris artifact from choroidal neovascularization (CNV). (a and b) A 6∗6-mm En face angiogram of the outer retina from a 62-year-old woman who were previously treated with 18 intravitreal anti-VEGF injections showing a homogenous and ill-defined network of vessels with a granular appearance (red dashed box). (c) Spectral-domain optical coherence tomography displaying a fusiform or spindle-shaped complex of high reflectivity located within the subretinal space.
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fig2: Distinguishing the choriocapillaris artifact from choroidal neovascularization (CNV). (a and b) A 6∗6-mm En face angiogram of the outer retina from a 62-year-old woman who were previously treated with 18 intravitreal anti-VEGF injections showing a homogenous and ill-defined network of vessels with a granular appearance (red dashed box). (c) Spectral-domain optical coherence tomography displaying a fusiform or spindle-shaped complex of high reflectivity located within the subretinal space.

Mentions: The qualitative tomographic OCTA review showed signs of CNV in 56 eyes. Eleven false-positive cases were observed on OCTA (Table 1). In six eyes that were previously treated with three or more intravitreal anti-VEGF injections, the patients had smaller but still notable CNV in the outer-retina segmentation of the OCTA but no apparent CNV on FA or detectable fluid accumulation on coregistered OCT B-scans (Figure 1). Chronic disciform scars (i.e., inactive CNV scars) were detected in 5 of 11 OCTA images with FA, but these appeared on OCTA as a homogenous and ill-defined network of vessels, with a granular appearance at the outer-retina segmentation (Figure 2). There were seven false-negative cases, and three of seven OCTA images showed a large amount of subretinal hemorrhage (Figure 3). The remaining images were of poor quality due to the motion artifacts and were believed to have no identifiable features of active CNV on OCTA. The specificity of OCTA for the detection of CNV was 67.6%, with a sensitivity of 86.5% and positive and negative predictive values of 80.4% and 76.7%, respectively (Table 2).


The Diagnostic Accuracy of Optical Coherence Tomography Angiography for Neovascular Age-Related Macular Degeneration: A Comparison with Fundus Fluorescein Angiography.

Gong J, Yu S, Gong Y, Wang F, Sun X - J Ophthalmol (2016)

Distinguishing the choriocapillaris artifact from choroidal neovascularization (CNV). (a and b) A 6∗6-mm En face angiogram of the outer retina from a 62-year-old woman who were previously treated with 18 intravitreal anti-VEGF injections showing a homogenous and ill-defined network of vessels with a granular appearance (red dashed box). (c) Spectral-domain optical coherence tomography displaying a fusiform or spindle-shaped complex of high reflectivity located within the subretinal space.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4821972&req=5

fig2: Distinguishing the choriocapillaris artifact from choroidal neovascularization (CNV). (a and b) A 6∗6-mm En face angiogram of the outer retina from a 62-year-old woman who were previously treated with 18 intravitreal anti-VEGF injections showing a homogenous and ill-defined network of vessels with a granular appearance (red dashed box). (c) Spectral-domain optical coherence tomography displaying a fusiform or spindle-shaped complex of high reflectivity located within the subretinal space.
Mentions: The qualitative tomographic OCTA review showed signs of CNV in 56 eyes. Eleven false-positive cases were observed on OCTA (Table 1). In six eyes that were previously treated with three or more intravitreal anti-VEGF injections, the patients had smaller but still notable CNV in the outer-retina segmentation of the OCTA but no apparent CNV on FA or detectable fluid accumulation on coregistered OCT B-scans (Figure 1). Chronic disciform scars (i.e., inactive CNV scars) were detected in 5 of 11 OCTA images with FA, but these appeared on OCTA as a homogenous and ill-defined network of vessels, with a granular appearance at the outer-retina segmentation (Figure 2). There were seven false-negative cases, and three of seven OCTA images showed a large amount of subretinal hemorrhage (Figure 3). The remaining images were of poor quality due to the motion artifacts and were believed to have no identifiable features of active CNV on OCTA. The specificity of OCTA for the detection of CNV was 67.6%, with a sensitivity of 86.5% and positive and negative predictive values of 80.4% and 76.7%, respectively (Table 2).

Bottom Line: Two independent readers calculated the sensitivity and specificity of OCTA in detecting CNV compared with FA.The specificity of OCTA for the detection of CNV was 67.6%, with sensitivity of 86.5%.OCTA may help in the noninvasive diagnosis of CNV and may provide a method for monitoring the evolution of CNV.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Shanghai General Hospital of Nanjing Medical University, Shanghai 200080, China; Department of Ophthalmology, Zhejiang Provincial People's Hospital, 158 Shangtang Road, Hangzhou, Zhejiang 310014, China.

ABSTRACT
Purpose. To describe the morphological characteristics and efficacy of OCTA in detecting CNV in nAMD. We retrospectively reviewed 53 patients (86 eyes) with suspected CNV secondary to wet AMD. All the patients underwent a multimodal assessment for CNV. Two independent readers calculated the sensitivity and specificity of OCTA in detecting CNV compared with FA. A qualitative analysis of OCTA was also performed to describe the morphological appearance of CNV. Among 86 eyes of 53 patients, 52 eyes were diagnosed as having CNV based on the FA imaging analysis. According to FA, CNV was classified as classic in 28 eyes, predominantly classic in 6 eyes, minimally classic in 9 eyes, and occult in 9 eyes. In 56 eyes, CNV was visualized on OCTA and corresponding OCT B-scans. In total, 46.4% (26/56) had well-circumscribed vessels, and 53.6% (30/56) showed poorly circumscribed vessels. There were 11 false positives and 7 false negatives using OCTA. The specificity of OCTA for the detection of CNV was 67.6%, with sensitivity of 86.5%. OCTA may help in the noninvasive diagnosis of CNV and may provide a method for monitoring the evolution of CNV.

No MeSH data available.


Related in: MedlinePlus