Sensitivity and Specificity of Multimodal Imaging in Characterizing Drusen
Sensitivity and Specificity of Multimodal Imaging in Characterizing Drusen
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DOI：
10.1016/j.oret.2020.04.013
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发表时间：
2020-10-01
影响因子：
4.5
通讯作者：
Staurenghi, Giovanni
中科院分区：
文献类型：
--
作者：
Cozzi, Mariano;Monteduro, Davide;Staurenghi, Giovanni
目的：计算不同成像方式在早期/中期年龄相关性黄斑变性（AMD）患者中的准确性。设计：前瞻性、观察性、横断面研究。参与者：早期或中期AMD患者。方法：所有参与者都接受了共焦扫描激光检眼镜的完整多模态成像评估，包括近红外反射（NIR），绿色眼底自发荧光（G-FAF），共焦假彩色，以及向左（DL）和向右（DR）偏移的后向模式。玻璃疣在地形学上分为小和中等（125 μ直径），而视网膜下玻璃疣样沉积物（SDD）分为点和带状表型。多模态成像被认为是检测玻璃疣和SDD不同亚型的参考标准。Cohen's kappa（k）被用来测试观察者之间对每种成像方式的一致性。主要结果测量：用不同的成像方式区分玻璃疣和SDDs亚型的能力。每种成像方式的2名阅片人之间的比率间可靠性范围为0.76至0.95。总体而言，大玻璃疣更好地确定与共焦假彩色成像（96.6%的灵敏度; 77.8%的特异性）。较小的玻璃疣可以用DR或DL逆行模式更好地检测到（分别为92%的敏感性; 58.3%的特异性和85.2%的敏感性; 83.3%的特异性）。彩色成像能更好地检测带状SDD（敏感性80.5%;特异性98.3%）。结论：近红外反射率和G-FAF可用于点状SDDs的分类，共聚焦假彩色法可用于带状SDDs的定性。在所有的成像方式中，retromode技术DR和DL可能是一种潜在的补充方式，以检测更小的玻璃疣。(C)2020年美国眼科学会
Purpose: To calculate the measures of accuracy of different imaging modalities in patients with early/intermediate age-related macular degeneration (AMD).Design: Prospective, observational, cross-sectional study.Participants: Patients with early or intermediate AMD.Methods: All participants underwent a completemultimodal imaging assessment with a confocal scanning laser ophthalmoscope, including near-infrared reflectance (NIR), green fundus autofluorescence (G-FAF), confocal pseudocolor, and retromode deviated to right (DR) and left (DL). Drusen were topographically divided as small and medium (125 mu diameter), whereas subretinal drusenoid deposits (SDDs) were divided into dot and ribbon phenotypes. Multimodal imaging was considered the reference standard for detecting different subtypes of drusen and SDDs. Cohen's kappa (k) was used to test interobserver agreement for each imaging modality.Main Outcome Measures: Capability to differentiate subtypes of drusen and SDDs with different imaging modalities.Results: A total of 100 eyes (62% were female participants) were evaluated. The inter-rate reliability between 2 readers for each imaging modality ranged between 0.76 and 0.95. Overall, large drusen were better identified with confocal pseudocolor imaging (96.6% sensitivity; 77.8% specificity). Smaller drusen were better detected with retromode modalities DR or DL (92% sensitivity; 58.3% specificity and 85.2% sensitivity; 83.3% specificity, respectively). Ribbon SDDs were better detected by color imaging (80.5% sensitivity; 98.3% specificity). Dot SDDs were well identified with NIR (83.1% sensitivity; 91.4% specificity) and G-FAF (84.6% sensitivity; 77.1% specificity).Conclusions: Near-infrared reflectance and G-FAF should be considered for classification of dot SDDs, and confocal pseudocolor is optimal for characterizing ribbon SDDs. Among all imaging modalities, retromode technology DR and DL may be a potential supplementary modality to detect even smaller drusen. (C) 2020 by the American Academy of Ophthalmology