OCT Angiography-Based Detection and Quantification of the Neovascular Network in Exudative AMD
OCT Angiography-Based Detection and Quantification of the Neovascular Network in Exudative AMD
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DOI：
10.1167/iovs.16-19741
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发表时间：
2016-11-01
影响因子：
4.4
通讯作者：
Fleckenstein, Monika
中科院分区：
文献类型：
--
作者：
Lindner, Moritz;Fang, Petra P.;Fleckenstein, Monika
目的。目的探讨光学相干断层扫描(OCT)血管成像对渗出型AMD新生血管网络的检测和量化价值。方法：研究方法。对被诊断为渗出型AMD的未接受治疗的患者进行OCT血管造影(OCT-A)前瞻性检查。新生血管网络的范围由三个独立的读数测量。计算类间相关系数和面积重叠系数(OC)，以评估测量之间的局部精确一致性。作为读者间协议的参考，在荧光素血管造影(FA)图像上进一步测量了新生血管网络的范围。结果。共有31只眼(27名患者，平均年龄82.5岁，15名女性)纳入研究。新生血管亚型：I型5只眼，II型11只眼，III型9只眼，混合型6只眼。新血管网络测量的读者间一致性为OCT-A为0.884，FA为0.636。重叠系数OCT-A为0.705(四分位数：0.450-0.76)，FA为0.704(IQR：0.673-0.750)。在III型和混合型病变中，面积一致性较弱。结论。基于光学相干断层扫描血管成像的新血管复合体在新生血管AMD中的测量是可行的，读者之间的一致性可与FA的值相媲美。这些结果强调了OCT-A作为一种非侵入性诊断工具诊断新生血管性AMD的潜力。然而，还需要进一步的研究来揭示单眼观察到的一致性较差的原因，并将OCT-A推向可靠的使用(例如，在阅读中心的背景下)。
PURPOSE. To investigate the potential of optical coherence tomography (OCT) angiography to detect and quantify the neovascular network in exudative AMD. METHODS. Treatment-naive eyes that were diagnosed with exudative AMD were prospectively examined by OCT angiography (OCT-A). The extent of the neovascular network was measured by three independent readers. Interclass-correlation coefficient and area overlap coefficients (OC) were calculated to assess locally precise agreement between measurements. As a reference for interreader agreement, the extent of the neovascular network was further measured on fluorescein angiography (FA) images. RESULTS. A total of 31 eyes (27 patients, mean age 82.5 years, 15 female) were included in the study. Neovascularization subtype was classified as type I in 5, type II in 11, type III in 9, and mixed in 6 eyes, respectively. Interreader agreement for measurements of the neovascular network was 0.884 for OCT-A and 0.636 for FA. Overlap coefficient was 0.705 (interquartile [IQR]: 0.450-0.76) for OCT-A and 0.704 (IQR: 0.673-0.750) for FA, respectively. Area agreement was weaker in type III and mixed lesions. CONCLUSIONS. Optical coherence tomography angiography-based measurements of the new vessel complex in neovascular AMD are feasible with interreader agreement comparable with the values obtained for FA. The results underscore the potential of OCT-A as a noninvasive diagnostic tool in neovascular AMD. Yet, further studies will be required to reveal the origin of poor agreement observed in single eyes and to advance OCT-A toward dependable use (e.g., in a reading center context).