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应用扫频源光学相干断层血管成像术检测年龄相关性黄斑变性的未经治疗性脉络膜新生血管。

DETECTION OF TREATMENT-NAIVE CHOROIDAL NEOVASCULARIZATION IN AGE-RELATED MACULAR DEGENERATION BY SWEPT SOURCE OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY.

机构信息

Karl Landsteiner Institute for Retinal Research and Imaging, Rudolf Foundation Hospital, Vienna, Austria.

Department of Ophthalmology, Rudolf Foundation Hospital, Vienna, Austria.

出版信息

Retina. 2018 Nov;38(11):2143-2149. doi: 10.1097/IAE.0000000000001832.

Abstract

PURPOSE

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.

METHODS

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.

RESULTS

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).

CONCLUSION

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.

摘要

目的

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。

方法

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。

结果

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)。

结论

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。

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