Corbelli Eleonora, Sacconi Riccardo, Rabiolo Alessandro, Mercuri Stefano, Carnevali Adriano, Querques Lea, Bandello Francesco, Querques Giuseppe
Department of Ophthalmology, University Vita-Salute, IRCCS Ospedale San Raffaele, Milan, Italy.
Eye Clinic, Department of Neurological, Biomedical and Movement Sciences, University of Verona, Verona, Italy.
Invest Ophthalmol Vis Sci. 2017 Oct 1;58(12):5201-5208. doi: 10.1167/iovs.17-22508.
To investigate the application of optical coherence tomography angiography (OCT-A) in evaluation of geographic atrophy (GA) secondary to age-related macular degeneration (AMD).
Patients with GA were prospectively enrolled and studied with blue fundus autofluorescence (FAF), en face structural OCT, and OCT-A. OCT-A images were acquired using a slab of whole choroid, whereas en face structural OCT images were obtained at the ellipsoid zone (EZ), at the choroidal (CH) level, and at the scleral (SC) level. Three readers independently measured the GA extension areas and evaluated the foveal sparing in each examination. Intraobserver/interobserver agreements and agreement between each couple of imaging techniques were assessed.
A total of 47 eyes (26 patients, mean age 76 ± 7 years) with GA (mean area using FAF: 8.77 ± 5.00 mm2) were included. Intraobserver and interobserver agreement was excellent for all imaging techniques (intraclass correlation coefficient [ICC] > 0.985), even if en face EZ structural OCT revealed the poorest quality agreement limits. Considering the analysis between each couple of imaging techniques, ICC was excellent between OCT-A compared with FAF (ICC: 0.995), followed by en face structural OCT at CH level (ICC: 0.992), at SC level (ICC: 0.986), and at EZ level (ICC: 0.973). No differences were detected between multifocal and monofocal GA lesions. Considering the evaluation of foveal involvement, lower agreements were disclosed between FAF and all other imaging techniques.
OCT-A is a reliable technique for easily visualizing and quantifying GA with the advantages, compared to current imaging techniques, of offering together both structural and blood flow information regarding retinal and choroidal layers and excluding choroidal neovascularization.
探讨光学相干断层扫描血管造影（OCT-A）在评估年龄相关性黄斑变性（AMD）继发地图样萎缩（GA）中的应用。
前瞻性纳入GA患者，采用蓝色眼底自发荧光（FAF）、表面结构光学相干断层扫描（OCT）和OCT-A进行研究。使用整个脉络膜层面采集OCT-A图像，而表面结构OCT图像则在椭圆体带（EZ）、脉络膜（CH）层面和巩膜（SC）层面获取。三位阅片者独立测量GA扩展区域，并在每次检查中评估中心凹保留情况。评估观察者内/观察者间的一致性以及每对成像技术之间的一致性。
共纳入47只GA眼（26例患者，平均年龄76±7岁）（FAF测量的平均面积：8.77±5.00mm²）。所有成像技术的观察者内和观察者间一致性均极佳（组内相关系数[ICC]>0.985），即使表面EZ结构OCT显示一致性极限质量最差。考虑每对成像技术之间分析，与FAF相比，OCT-A之间的ICC极佳（ICC：0.995），其次是CH层面的表面结构OCT（ICC：0.992）、SC层面（ICC：0.986）和EZ层面（ICC：0.973）。多灶性和单灶性GA病变之间未检测到差异。考虑中心凹受累情况评估，FAF与所有其他成像技术之间的一致性较低。
OCT-A是一种可靠的技术，可轻松可视化和量化GA，与当前成像技术相比，其优点是能同时提供视网膜和脉络膜层的结构和血流信息，并排除脉络膜新生血管。
