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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

Optical coherence tomography angiography (OCTA) of treated choroidal neovascularization. (a) A 3∗3-mm OCTA en face projection image from an 84-year-old man who was treated with 20 intravitreal anti-VEGF injections. Note the large diameter of the trunk vessels (red arrow). At the periphery there appears to be a defined anastomotic connection around the border (blue arrows). (b) A 3∗3-mm En face angiogram of the neovascular membrane from a 65-year-old man who were previously treated with 18 intravitreal anti-VEGF injections showing the red dashed circle that encompasses the trunk vessels of the lesion. Note the neovascular complex with vessels radiating in all directions from the center and the terminal loops of the vessels (blue arrows). (c) A 3∗3-mm OCTA en face projection image from a 65-year-old man who were treated with 16 intravitreal anti-VEGF injections. Note the long extent of the vessels as they reach the edge of the lesion (red arrows).
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fig5: Optical coherence tomography angiography (OCTA) of treated choroidal neovascularization. (a) A 3∗3-mm OCTA en face projection image from an 84-year-old man who was treated with 20 intravitreal anti-VEGF injections. Note the large diameter of the trunk vessels (red arrow). At the periphery there appears to be a defined anastomotic connection around the border (blue arrows). (b) A 3∗3-mm En face angiogram of the neovascular membrane from a 65-year-old man who were previously treated with 18 intravitreal anti-VEGF injections showing the red dashed circle that encompasses the trunk vessels of the lesion. Note the neovascular complex with vessels radiating in all directions from the center and the terminal loops of the vessels (blue arrows). (c) A 3∗3-mm OCTA en face projection image from a 65-year-old man who were treated with 16 intravitreal anti-VEGF injections. Note the long extent of the vessels as they reach the edge of the lesion (red arrows).

Mentions: In the 56 eyes with CNV associated with nAMD, 26 eyes had well-circumscribed vessels in the CNV area, and 30 eyes showed poorly circumscribed vessels on the OCTA images. We found four eyes at the transition point between dry and nAMD. Among these, one patient complained of reduced vision in both eyes for one week. Drusen deposits, disrupted of RPE, and defect of the photoreceptor layer were visible on OCT B-scans. A decorrelation signal was noted at the outer-retina level on OCTA. The FA also showed hyperfluorescence in the region of the CNV (Figure 4). The images of another case showed mild drusenoid pigment epithelial detachment (right eye) and a macular membrane with eccentric lesions (left eye) without detectable fluid accumulation on the OCT B-scans, but we found the presence of a decorrelation signal at the outer-retina level on OCTA and a leaky CNV in the late phase of FA. In 12 eyes that were previously treated with more than 10 intravitreal anti-VEGF injections, the vascular networks shared similar characteristics, with prominent vascular loops and anastomotic connections (Figure 5). Eight of the 12 eyes had large main trunk vessels, with the vessels radiating in a branching pattern, in all directions either from the center of the lesion or from one side of the lesion.


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)

Optical coherence tomography angiography (OCTA) of treated choroidal neovascularization. (a) A 3∗3-mm OCTA en face projection image from an 84-year-old man who was treated with 20 intravitreal anti-VEGF injections. Note the large diameter of the trunk vessels (red arrow). At the periphery there appears to be a defined anastomotic connection around the border (blue arrows). (b) A 3∗3-mm En face angiogram of the neovascular membrane from a 65-year-old man who were previously treated with 18 intravitreal anti-VEGF injections showing the red dashed circle that encompasses the trunk vessels of the lesion. Note the neovascular complex with vessels radiating in all directions from the center and the terminal loops of the vessels (blue arrows). (c) A 3∗3-mm OCTA en face projection image from a 65-year-old man who were treated with 16 intravitreal anti-VEGF injections. Note the long extent of the vessels as they reach the edge of the lesion (red arrows).
© Copyright Policy - open-access
Related In: Results  -  Collection

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getmorefigures.php?uid=PMC4821972&req=5

fig5: Optical coherence tomography angiography (OCTA) of treated choroidal neovascularization. (a) A 3∗3-mm OCTA en face projection image from an 84-year-old man who was treated with 20 intravitreal anti-VEGF injections. Note the large diameter of the trunk vessels (red arrow). At the periphery there appears to be a defined anastomotic connection around the border (blue arrows). (b) A 3∗3-mm En face angiogram of the neovascular membrane from a 65-year-old man who were previously treated with 18 intravitreal anti-VEGF injections showing the red dashed circle that encompasses the trunk vessels of the lesion. Note the neovascular complex with vessels radiating in all directions from the center and the terminal loops of the vessels (blue arrows). (c) A 3∗3-mm OCTA en face projection image from a 65-year-old man who were treated with 16 intravitreal anti-VEGF injections. Note the long extent of the vessels as they reach the edge of the lesion (red arrows).
Mentions: In the 56 eyes with CNV associated with nAMD, 26 eyes had well-circumscribed vessels in the CNV area, and 30 eyes showed poorly circumscribed vessels on the OCTA images. We found four eyes at the transition point between dry and nAMD. Among these, one patient complained of reduced vision in both eyes for one week. Drusen deposits, disrupted of RPE, and defect of the photoreceptor layer were visible on OCT B-scans. A decorrelation signal was noted at the outer-retina level on OCTA. The FA also showed hyperfluorescence in the region of the CNV (Figure 4). The images of another case showed mild drusenoid pigment epithelial detachment (right eye) and a macular membrane with eccentric lesions (left eye) without detectable fluid accumulation on the OCT B-scans, but we found the presence of a decorrelation signal at the outer-retina level on OCTA and a leaky CNV in the late phase of FA. In 12 eyes that were previously treated with more than 10 intravitreal anti-VEGF injections, the vascular networks shared similar characteristics, with prominent vascular loops and anastomotic connections (Figure 5). Eight of the 12 eyes had large main trunk vessels, with the vessels radiating in a branching pattern, in all directions either from the center of the lesion or from one side of the lesion.

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