Stehouwer M, Verbraak F D, Schlingemann R O, van Leeuwen T G
Department of Ophthalmology, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
Department of Biomedical Engineering and Physics, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
Graefes Arch Clin Exp Ophthalmol. 2016 Jan;254(1):37-41. doi: 10.1007/s00417-015-2997-z. Epub 2015 Apr 23.
The purpose is to evaluate the interdevice and interobserver agreements between the SL SCAN-1 (a FD-OCT integrated into a common slit lamp) and a standard stand-alone FD-OCT device (the Cirrus) with regard to the presence or absence of signs of leakage in the retina in patients with exudative AMD and treated with anti-VEGF.
Fifty-six patients, known to have exudative AMD and under treatment with anti-VEGF agents, were included. During a regular follow-up, OCT scans were made with the Cirrus (macular-cube pattern) and the SL SCAN-1 (radial-scan pattern). All scans were graded by two medical retina specialists for signs of intraretinal cysts, subretinal fluid accumulation, and thickening of the neurosensory retina. Presence of signs of leakage was concluded if one or more of the three signs were present.
In 91 % of the patients, the observers made identical conclusions for both devices of the presence of signs of leakage, resulting in an interdevice Kappa coefficient of 0.87. For the scans with disagreement about the presence or absence of signs of leakage, positive and negative conclusions were equally distributed between both devices, and differences were restricted to more subtle signs of leakage.
The interdevice Kappa coefficient of 0.87 shows a high agreement between the SL SCAN-1 and the Cirrus in grading signs of leakage in exudative AMD. OCT images play a pivotal role in the diagnosis and management of exudative diseases like AMD, and the SL SCAN-1 provides a very efficient approach to these patients with the integration of the FD-OCT device into a common slit lamp.
评估SL SCAN-1（一种集成在普通裂隙灯中的频域光学相干断层扫描（FD-OCT）设备）与标准独立FD-OCT设备（Cirrus）在湿性年龄相关性黄斑变性（AMD）抗血管内皮生长因子（VEGF）治疗患者视网膜渗漏体征方面的设备间和观察者间一致性。
纳入56例已知患有湿性AMD且正在接受抗VEGF药物治疗的患者。在定期随访期间，使用Cirrus（黄斑立方模式）和SL SCAN-1（径向扫描模式）进行光学相干断层扫描（OCT）。所有扫描均由两位视网膜专科医生对视网膜内囊肿、视网膜下液积聚和神经感觉视网膜增厚的体征进行分级。如果出现三个体征中的一个或多个，则判定存在渗漏体征。
在91%的患者中，观察者对两种设备是否存在渗漏体征得出相同结论，设备间卡帕系数为0.87。对于在渗漏体征有无方面存在分歧的扫描，两种设备的阳性和阴性结论分布均匀，差异仅限于更细微的渗漏体征。
设备间卡帕系数0.87表明SL SCAN-1和Cirrus在湿性AMD渗漏体征分级方面具有高度一致性。OCT图像在AMD等渗出性疾病的诊断和管理中起着关键作用，SL SCAN-1将FD-OCT设备集成到普通裂隙灯中，为这些患者提供了一种非常有效的方法。
