Newcastle Eye Centre, Ophthalmology Department, Royal Victoria Infirmary, Newcastle-upon-tyne, NE1 4LP, UK.
Eye (Lond). 2018 Apr;32(4):661-672. doi: 10.1038/eye.2018.2. Epub 2018 Mar 30.
PurposeTo assess OCT angiography (OCTA) effectiveness at detecting choroidal neovascularization (CNV) in cases of suspected neovascular age related macular degeneration (nAMD), chronic central serous retinopathy (cCSR) and pathological myopia compared to FFA and how it compares to a multimodal approach (OCT, FFA and ICGA) for detecting the vascular network.MethodsThis was a retrospective observational cohort study of patients who had clinical and/or OCT findings suggestive of CNV, having further investigation with FFA, with or without ICG, and had same day OCTA using the Heidelberg Spectralis OCT2 beta angiography module. Multimodal imaging interpretation was compared to OCTA images. OCTA images were also analysed for inter-rater reliability (using kappa statistic). The diagnostic accuracy of OCTA was compared to FFA (using Cochran's Q, p<0.05). OCTA was also compared to a multimodal approach in defining a vascular network.ResultsOverall sensitivity of OCTA compared to FFA was 71% and specificity of 81% (p=0.108). Subgroup analysis for OCTA vs FFA for detecting classic nAMD/type II CNV sensitivity was 100% and specificity of 76% (p<0.05). OCTA vs FFA for detecting occult nAMD/type-I CNV sensitivity was 47% and specificity of 76%, (p=0.248). OCTA was better than FFA at defining a vascular network overall, when OCT was suspicious (59% vs 49%).ConclusionsOCTA was better at detecting classic nAMD/type II CNV compared to FFA and for defining a vascular network in nAMD compared to FFA and ICGA. It was able to aid in making the diagnosis in cases where evidence of CNV was uncertain following FFA/ICGA.
目的
评估 OCT 血管造影术（OCTA）在疑似新生血管性年龄相关性黄斑变性（nAMD）、慢性中心性浆液性脉络膜视网膜病变（cCSR）和病理性近视患者中检测脉络膜新生血管（CNV）的有效性，并与荧光素血管造影（FFA）比较，以及与 OCT、FFA 和吲哚青绿血管造影（ICGA）的多模态方法比较，以检测血管网络。
方法
这是一项回顾性观察性队列研究，纳入了具有临床和/或 OCT 发现提示 CNV 的患者，进一步进行了 FFA 检查，有或没有 ICG，并在同一天使用海德堡 Spectralis OCT2 beta 血管造影模块进行了 OCTA。多模态成像解读与 OCTA 图像进行比较。还对 OCTA 图像进行了组内一致性分析（使用 Kappa 统计）。比较 OCTA 与 FFA 的诊断准确性（使用 Cochran's Q，p<0.05）。还比较了 OCTA 与多模态方法在定义血管网络方面的差异。
结果
OCTA 与 FFA 相比，总体敏感性为 71%，特异性为 81%（p=0.108）。OCTA 与 FFA 检测经典 nAMD/II 型 CNV 的敏感性为 100%，特异性为 76%（p<0.05）。OCTA 与 FFA 检测隐匿性 nAMD/I 型 CNV 的敏感性为 47%，特异性为 76%（p=0.248）。OCTA 在 OCT 可疑时，总体上比 FFA 更能定义血管网络（59%比 49%）。
结论
与 FFA 相比，OCTA 更能检测经典 nAMD/II 型 CNV，与 FFA 和 ICGA 相比，OCTA 更能定义 nAMD 的血管网络。在 FFA/ICGA 后 CNV 证据不确定的情况下，OCTA 能够帮助做出诊断。
