Eye Clinic, Department of Biomedical and Clinical Science "Luigi Sacco", Sacco Hospital, University of Milan, via G.B Grassi 74, 20157, Milan, Italy.
Doheny Eye Institute, California, Los Angeles, USA.
Graefes Arch Clin Exp Ophthalmol. 2021 Feb;259(2):291-299. doi: 10.1007/s00417-020-04821-6. Epub 2020 Jul 3.
To evaluate the ability of optical coherence tomography angiography (OCTA) to detect macular neovascularization (MNV) in eyes with atrophy compared with fluorescein angiography (FA), indocyanine green angiography (ICGA), and optical coherence tomography (OCT).
In this prospective study, eyes with MNV and atrophy (termed macular atrophy or MA) secondary to age-related macular degeneration (AMD), and AMD eyes with geographic atrophy (GA) without MNV underwent multimodal imaging with FA, ICGA, structural OCT, and OCTA. The presence of MNV was determined using all imaging modalities by senior retina specialists and was considered the gold standard reference. Each individual imaging modality was then evaluated independently by two expert readers for the presence of MNV in a masked fashion. Morphologic characteristics of the MNV were evaluated on the custom OCTA slab.
Twenty-one patients with MA+MNV and 21 with GA only were enrolled. Manual segmentation on OCTA allowed detection of the MNV in 95.2% of eyes with MA+MNV and in 4.7% of eyes with GA, showing high specificity (95.2%) and sensitivity (95.2%). FA, ICGA, and OCT detected MNV in 57.1%, 52.3%, and 66.7% of eyes with MA+MNV and in 14.2%, 9.5%, and 42.8% with GA. Sensitivity and specificity were 85.7% and 57.1% for FA, 90.5% and 52.4% for ICGA, and 66.7% and 57.1% for OCT.
OCTA appears to be superior to other imaging modalities for identification of MNV in eyes with macular atrophy. OCTA should be considered as part of the multimodal imaging evaluation of eyes with atrophy, particularly in the context of clinical trials.
评估光学相干断层扫描血管造影术（OCTA）检测与年龄相关性黄斑变性（AMD）相关萎缩性黄斑新生血管（MNV）的能力，并与荧光素血管造影（FA）、吲哚菁绿血管造影（ICGA）和光学相干断层扫描（OCT）进行比较。
在这项前瞻性研究中，对 MNV 合并萎缩（称为黄斑萎缩或 MA）的 AMD 眼和无 MNV 的 AMD 性地图状萎缩（GA）眼进行 FA、ICGA、结构 OCT 和 OCTA 等多模态成像。通过资深视网膜专家使用所有成像方式确定 MNV 的存在，并将其视为金标准参考。然后，两位专家读者以盲法独立评估每种单独的成像方式是否存在 MNV。MNV 的形态特征在定制的 OCTA 切片上进行评估。
共纳入 21 例 MA+MNV 患者和 21 例 GA 患者。OCTA 手动分割可检测到 95.2%的 MA+MNV 眼和 4.7%的 GA 眼的 MNV，具有较高的特异性（95.2%）和敏感性（95.2%）。FA、ICGA 和 OCT 在 57.1%、52.3%和 66.7%的 MA+MNV 眼中和 14.2%、9.5%和 42.8%的 GA 眼中检测到 MNV。FA 的敏感性和特异性分别为 85.7%和 57.1%，ICGA 为 90.5%和 52.4%，OCT 为 66.7%和 57.1%。
OCTA 似乎优于其他成像方式，可用于识别 MA 眼中的 MNV。OCTA 应作为萎缩性眼病多模态成像评估的一部分，特别是在临床试验中。
