Cozzi Mariano, Monteduro Davide, Parrulli Salvatore, Corvi Federico, Zicarelli Federico, Corradetti Giulia, Sadda SriniVas R, Staurenghi Giovanni
Eye Clinic, Department of Biomedical and Clinical Science "Luigi Sacco," Luigi Sacco Hospital, University of Milan, Milan, Italy.
Eye Clinic, Department of Biomedical and Clinical Science "Luigi Sacco," Luigi Sacco Hospital, University of Milan, Milan, Italy.
Ophthalmol Retina. 2020 Oct;4(10):987-995. doi: 10.1016/j.oret.2020.04.013. Epub 2020 Apr 23.
To calculate the measures of accuracy of different imaging modalities in patients with early/intermediate age-related macular degeneration (AMD).
Prospective, observational, cross-sectional study.
Patients with early or intermediate AMD.
All participants underwent a complete multimodal imaging assessment with a confocal scanning laser ophthalmoscope, including near-infrared reflectance (NIR), green fundus autofluorescence (G-FAF), confocal pseudocolor, and retromode deviated to right (DR) and left (DL). Drusen were topographically divided as small and medium (≤125 μ diameter) and large (>125 μ diameter), whereas subretinal drusenoid deposits (SDDs) were divided into dot and ribbon phenotypes. Multimodal imaging was considered the reference standard for detecting different subtypes of drusen and SDDs. Cohen's kappa (k) was used to test interobserver agreement for each imaging modality.
Capability to differentiate subtypes of drusen and SDDs with different imaging modalities.
A total of 100 eyes (62% were female participants) were evaluated. The inter-rate reliability between 2 readers for each imaging modality ranged between 0.76 and 0.95. Overall, large drusen were better identified with confocal pseudocolor imaging (96.6% sensitivity; 77.8% specificity). Smaller drusen were better detected with retromode modalities DR or DL (92% sensitivity; 58.3% specificity and 85.2% sensitivity; 83.3% specificity, respectively). Ribbon SDDs were better detected by color imaging (80.5% sensitivity; 98.3% specificity). Dot SDDs were well identified with NIR (83.1% sensitivity; 91.4% specificity) and G-FAF (84.6% sensitivity; 77.1% specificity).
Near-infrared reflectance and G-FAF should be considered for classification of dot SDDs, and confocal pseudocolor is optimal for characterizing ribbon SDDs. Among all imaging modalities, retromode technology DR and DL may be a potential supplementary modality to detect even smaller drusen.
计算不同成像方式在早/中年年龄相关性黄斑变性（AMD）患者中的准确性指标。
前瞻性、观察性横断面研究。
早发或中度AMD患者。
所有参与者均使用共焦扫描激光眼科显微镜进行了完整的多模态成像评估，包括近红外反射（NIR）、绿色眼底自发荧光（G-FAF）、共焦伪彩色成像以及向右（DR）和向左（DL）的后向模式。玻璃膜疣在地形学上分为小和中（直径≤125μm）以及大（直径>125μm），而视网膜下玻璃膜疣样沉积物（SDD）分为点状和带状表型。多模态成像被视为检测不同亚型玻璃膜疣和SDD的参考标准。使用Cohen's kappa（κ）检验每种成像方式的观察者间一致性。
用不同成像方式区分玻璃膜疣和SDD亚型的能力。
共评估了100只眼（62%为女性参与者）。每种成像方式的两名阅片者之间的组内信度在0.76至0.95之间。总体而言，共焦伪彩色成像对大玻璃膜疣的识别更好（敏感性96.6%；特异性77.8%）。较小的玻璃膜疣用后向模式DR或DL检测效果更好（敏感性分别为92%；特异性58.3%和敏感性85.2%；特异性83.
