Karl Landsteiner Institute for Retinal Research and Imaging, Rudolf Foundation Hospital, Vienna, Austria.
Department of Ophthalmology, Rudolf Foundation Hospital, Vienna, Austria.
Retina. 2018 Nov;38(11):2143-2149. doi: 10.1097/IAE.0000000000001832.
To compare the detection rate of choroidal neovascularization (CNV) in treatment-naive neovascular age-related macular degeneration by swept source optical coherence tomography angiography (SS-OCTA, Topcon's DRI Triton) working at 1,050 nm wavelength versus fluorescence angiography.
Cross-sectional analysis of 156 eyes (107 neovascular age-related macular degeneration and 49 dry AMD) in 98 patients, previously diagnosed by multimodal imaging using fluorescein (FA) and indocyanine green angiography (Heidelberg's Spectralis) in a tertiary retina center, evaluated by SS-OCTA 4.5 mm × 4.5 mm and 6 mm × 6 mm macular cubes. Main outcome measures were sensitivity and specificity of SS-OCTA in AMD. Potential factors influencing CNV detection rate were analyzed.
Swept source optical coherence tomography angiography detected CNV in 81 of 107 eyes, resulting in a sensitivity of 75.7%. In 49 eyes with dry AMD, no CNV could be identified (specificity 100%). A statistical significance was calculated for nondetection of treatment-naive CNV by SS-OCTA in pigment epithelial detachment over 400 μm (P = 0.0238).
Topcon's SS-OCTA was not able to detect all CNV lesions. Large pigment epithelial detachments were associated with signal loss. Fluorescence angiography still remains the gold standard, but the tested SS-OCTA device can be considered as a feasible additional diagnostic tool in AMD.
比较 1050nm 波长的扫频源光相干断层扫描血管造影(SS-OCTA,Topcon 的 DRI Triton)与荧光血管造影在治疗初发性新生血管性年龄相关性黄斑变性(nAMD)中对脉络膜新生血管(CNV)的检测率。
对 98 例患者的 156 只眼(107 只 nAMD 和 49 只干性 AMD)进行横断面分析,这些患者之前在一家三级视网膜中心通过多模态成像(使用荧光素 FA 和吲哚青绿血管造影 Heidelberg 的 Spectralis)诊断,并使用 SS-OCTA 4.5mm×4.5mm 和 6mm×6mm 黄斑立方进行评估。主要观察指标为 SS-OCTA 在 AMD 中的敏感性和特异性。分析影响 CNV 检测率的潜在因素。
SS-OCTA 在 107 只眼中检测到 81 只眼的 CNV,敏感性为 75.7%。在 49 只干性 AMD 眼中,未检测到 CNV(特异性为 100%)。SS-OCTA 未检测到大于 400μm 的色素上皮脱离中的治疗初发性 CNV 具有统计学意义(P=0.0238)。
Topcon 的 SS-OCTA 未能检测到所有的 CNV 病变。大的色素上皮脱离与信号丢失有关。荧光血管造影仍然是金标准,但所测试的 SS-OCTA 设备可被视为 AMD 的一种可行的附加诊断工具。