Division of Epidemiology and Clinical Research, National Eye Institute, National Institutes of Health, Bethesda, MD 20892, USA.
Eye (Lond). 2010 May;24(5):775-83. doi: 10.1038/eye.2009.211. Epub 2009 Aug 21.
To determine whether optical coherence tomography (OCT) device-type influences clinical grading of OCT imaging in the context of exudative age-related macular degeneration (AMD).
Ninety-six paired OCT scans from 49 patients with active exudative AMD were obtained on both the time-domain Stratus OCT system and the spectral-domain Cirrus OCT system at the same visit. Three independent graders judged each scan for the presence of intraretinal fluid (IRF) or subretinal fluid (SRF). The degree of grader consensus was evaluated and the ability of the systems to detect the presence of disease activity was analysed.
Cirrus OCT generated a higher degree of inter-grader consensus than Stratus OCT with higher intraclass correlation coefficients for all parameters analysed. A pair-wise comparison of Cirrus OCT with Stratus OCT systems revealed that Cirrus-based gradings more frequently reported the presence of SRF and IRF and detected overall neovascular activity at a higher rate (P<0.05) compared with Stratus-based gradings.
The choice of time-domain (Stratus) vs spectra-domain (Cirrus) OCT systems has a measurable impact on clinical decision making in exudative AMD. Spectral-domain OCT systems may be able to generate more consensus in clinical interpretation and, in particular cases, detect disease activity not detected by time-domain systems. Clinical trials using OCT-based clinical evaluations of exudative AMD may need to account for these inter-system differences in planning and analysis.
确定光学相干断层扫描（OCT）设备类型是否会影响渗出性年龄相关性黄斑变性（AMD）的 OCT 成像临床分级。
在同一次就诊时，从 49 例活动性渗出性 AMD 患者中获得了 96 对 OCT 扫描，分别来自时域 Stratus OCT 系统和频域 Cirrus OCT 系统。三名独立的分级员对每个扫描进行评估，以判断是否存在视网膜内液（IRF）或视网膜下液（SRF）。评估了分级员之间的一致性程度，并分析了两种系统检测疾病活动的能力。
Cirrus OCT 生成的分级员之间的一致性程度高于 Stratus OCT，对于分析的所有参数，其组内相关系数都更高。Cirrus OCT 与 Stratus OCT 系统的两两比较显示，Cirrus 分级更频繁地报告 SRF 和 IRF 的存在，并以更高的比率（P<0.05）检测到整体新生血管活动，而 Stratus 分级则不然。
选择时域（Stratus）与频域（Cirrus）OCT 系统对视盘渗出性 AMD 的临床决策有一定的影响。频域 OCT 系统可能能够在临床解释中产生更高的共识，并且在某些情况下，能够检测到时域系统无法检测到的疾病活动。使用基于 OCT 的渗出性 AMD 临床评估的临床试验可能需要在规划和分析中考虑这些系统间的差异。
