The use of optical coherence tomography angiography for detecting choroidal neovascularization, compared to standard multimodal imaging
The use of optical coherence tomography angiography for detecting choroidal neovascularization, compared to standard multimodal imaging
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作者：
Soomro, T.;Talks, J.
目的评价OCT血管成像(OCTA)对可疑新生血管年龄相关性黄斑变性(NAMD)、慢性中心性浆液性视网膜病变(CCSR)和病理性近视患者脉络膜新生血管(CNV)的检测效果，并与多模式方法(OCT、FFA和ICGA)进行比较。方法对临床和/或OCT结果提示CNV的患者进行了一项回顾性观察队列研究，其中FFA有或没有ICG，并在同一天使用Heidelberg SpectralisOCT2血管成像模块进行了OCTA。将多模式成像解释与OCTA图像进行比较。还对OCTA图像进行了评分者间可靠性分析(使用kappa统计)。比较OCTA和FFA的诊断准确性(采用Cochran‘s Q，po0.05)。结果OCTA的总体敏感性为71%，特异性为81%(p=0.108)。OCTA与FFA检测NAMD/II型CNV的敏感度为100%，特异度为76%(P<0.05)。OCTA与FFA检测隐匿性NAMD/I型CNV的敏感度为47%，特异度为76%(P=0.248)。当OCT可疑时，OCTA在显示血管网络方面优于FFA(59%比49%)。结论OCTA对典型NAMD/II型CNV的检出优于FFA，对NAMD血管网络的显示优于FFA和ICGA。在FFA/ICGA后CNV证据不确定的情况下，它能够帮助做出诊断。
Purpose To assess OCT angiography (OCTA) effectiveness at detecting choroidal neovascularization (CNV) in cases of suspected neovascular age related macular degeneration (nAMD), chronic central serous retinopathy (cCSR) and pathological myopia compared to FFA and how it compares to a multimodal approach (OCT, FFA and ICGA) for detecting the vascular network.Methods This was a retrospective observational cohort study of patients who had clinical and/or OCT findings suggestive of CNV, having further investigation with FFA, with or without ICG, and had same day OCTA using the Heidelberg Spectralis OCT2 beta angiography module. Multimodal imaging interpretation was compared to OCTA images. OCTA images were also analysed for inter-rater reliability (using kappa statistic). The diagnostic accuracy of OCTA was compared to FFA (using Cochran's Q, po0.05). OCTA was also compared to a multimodal approach in defining a vascular network.Results Overall sensitivity of OCTA compared to FFA was 71% and specificity of 81% (p= 0.108). Subgroup analysis for OCTA vs FFA for detecting classic nAMD/type II CNV sensitivity was 100% and specificity of 76% (po0.05). OCTA vs FFA for detecting occult nAMD/type-I CNV sensitivity was 47% and specificity of 76%, (p= 0.248). OCTA was better than FFA at defining a vascular network overall, when OCT was suspicious (59% vs 49%).Conclusions OCTA was better at detecting classic nAMD/type II CNV compared to FFA and for defining a vascular network in nAMD compared to FFA and ICGA. It was able to aid in making the diagnosis in cases where evidence of CNV was uncertain following FFA/ICGA.