Al-Khersan Hasenin, Russell Jonathan F, Lazzarini Thomas A, Scott Nathan L, Hinkle John W, Patel Nimesh A, Yannuzzi Nicolas A, Fowler Benjamin J, Hussain Rehan M, Barikian Anita, Sridhar Jayanth, Russell Stephen R, Haddock Luis J, Smiddy William E, Hariprasad Seenu M, Shi Yingying, Wang Liang, Feuer William, Gregori Giovanni, Rosenfeld Philip J
Bascom Palmer Eye Institute, Miami, Florida, USA.
Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Am J Ophthalmol. 2021 Apr;224:292-300. doi: 10.1016/j.ajo.2020.11.020. Epub 2020 Dec 11.
We compared the ability of ophthalmologists to identify neovascularization (NV) in patients with proliferative diabetic retinopathy using swept-source optical coherence tomography angiography (SS-OCTA) and fluorescein angiography (FA).
Retrospective study comparing diagnostic instruments.
Eyes with proliferative diabetic retinopathy or severe nonproliferative diabetic retinopathy and a high suspicion of NV based on clinical examination were imaged using SS-OCTA and FA at the same visit. Two separate grading sets consisting of scrambled, anonymized SS-OCTA and FA images were created. The ground truth for presence of NV was established by consensus of 2 graders with OCTA experience who did not participate in the subsequent assessment of NV in this study. The 2 anonymized image sets were graded for presence or absence of NV by 12 other graders that included 2 residents, 6 vitreoretinal fellows, and 4 vitreoretinal attending physicians. The percentage of correct grading of NV using SS-OCTA and FA was assessed for each grader and across grader training levels.
Forty-seven eyes from 24 patients were included in this study. Overall, the mean percentage of correct NV grading was 87.8% using SS-OCTA with B-scans and 86.2% using FA (P = .92). Assessing each grader individually, there was no statistically significant asymmetry in correct grading using SS-OCTA and FA.
Ophthalmologists across training levels were able to identify diabetic NV with equal accuracy using SS-OCTA and FA. Based on these results, SS-OCTA may be an appropriate standalone modality for diagnosing diabetic NV.
我们比较了眼科医生使用扫频光学相干断层扫描血管造影（SS-OCTA）和荧光素血管造影（FA）识别增殖性糖尿病视网膜病变患者新生血管形成（NV）的能力。
比较诊断工具的回顾性研究。
对患有增殖性糖尿病视网膜病变或严重非增殖性糖尿病视网膜病变且基于临床检查高度怀疑有NV的眼睛在同一次就诊时进行SS-OCTA和FA成像。创建了两个单独的分级数据集，由打乱顺序、匿名的SS-OCTA和FA图像组成。NV存在与否的真实情况由2名有OCTA经验但未参与本研究后续NV评估的分级人员达成共识确定。另外12名分级人员对这两个匿名图像集进行NV存在与否的分级，其中包括2名住院医师、6名玻璃体视网膜专科住院医生和4名玻璃体视网膜主治医师。评估了每位分级人员以及不同分级人员培训水平下使用SS-OCTA和FA对NV正确分级的百分比。
本研究纳入了24例患者的47只眼睛。总体而言，使用带有B扫描的SS-OCTA对NV正确分级的平均百分比为87.8%，使用FA为86.2%（P = 0.92）。单独评估每位分级人员时，使用SS-OCTA和FA进行正确分级没有统计学上的显著差异。
不同培训水平的眼科医生使用SS-OCTA和FA识别糖尿病性NV的准确性相同。基于这些结果，SS-OCTA可能是诊断糖尿病性NV的一种合适的独立检查方法。
