Cologne Image Reading Center, Department of Ophthalmology, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.
Department of Ophthalmology, Helios University Hospital Wuppertal, University of Witten-Herdecke, Wuppertal, Germany.
Graefes Arch Clin Exp Ophthalmol. 2022 Jan;260(1):113-119. doi: 10.1007/s00417-021-05229-6. Epub 2021 Jul 6.
To compare swept-source (SS) versus spectral-domain (SD) optical coherence tomography angiography (OCTA) for the detection of macular neovascularization (MNV).
In this prospective cohort study, 72 eyes of 54 patients with subretinal hyperreflective material (SHRM) and/or pigment epithelial detachment (PED) on OCT possibly corresponding to MNV in at least one eye were included. OCTA scans were acquired using two devices, the PLEX Elite 9000 SS-OCTA and the Spectralis SD-OCTA. Fluorescein angiography (FA) was used as reference. Two graders independently evaluated en face OCTA images using a preset slab as well as a manually modified slab, followed by a combination of en face and cross-sectional OCTA.
Sensitivity (specificity) for the automated slabs was 51.7% (93.0%) for SS-OCTA versus 58.6% (95.3%) for SD-OCTA. Manual modification of segmentation increased sensitivity to 79.3% for SS-OCTA but not for SD-OCTA (58.6%). The combination of en face OCTA with cross-sectional OCTA reached highest sensitivity values (SS-OCTA: 82.8%, SD-OCTA: 86.2%), and lowest number of cases with discrepancies between SS-OCTA and SD-OCTA (4.2%). Fleiss kappa as measure of concordance between FA, SS-OCTA, and SD-OCTA was 0.56 for the automated slabs, 0.60 for the manual slabs, and 0.73 (good agreement) for the combination of en face OCTA with cross-sectional OCTA. Concordance to FA was moderate for the automated slabs and good for manual slabs and combination with cross-sectional OCTA of both devices.
Both devices reached comparable results regarding the detection of MNV on OCTA. Sensitivity for MNV detection and agreement between devices was best when evaluating a combination of en face and cross-sectional OCTA.
比较扫频源（SS）与谱域（SD）光学相干断层扫描血管造影（OCTA）在检测黄斑新生血管（MNV）中的作用。
在这项前瞻性队列研究中，纳入了 72 只眼 54 例患者的视网膜下高反射物质（SHRM）和/或 OCT 上的色素上皮脱离（PED），这些患者的至少一只眼存在可能与 MNV 相对应的物质。使用两种设备（PLEX Elite 9000 SS-OCTA 和 Spectralis SD-OCTA）采集 OCTA 扫描。使用预设平板和手动修改平板，对平面 OCTA 图像进行了两位分级评估，然后结合平面和横断面 OCTA。
自动平板的 SS-OCTA 敏感性（特异性）为 51.7%（93.0%），SD-OCTA 为 58.6%（95.3%）。对分割的手动修改将 SS-OCTA 的敏感性提高到 79.3%，但 SD-OCTA 没有（58.6%）。平面 OCTA 与横断面 OCTA 的结合达到了最高的敏感性值（SS-OCTA：82.8%，SD-OCTA：86.2%），并且 SS-OCTA 和 SD-OCTA 之间差异的病例数最少（4.2%）。FA、SS-OCTA 和 SD-OCTA 之间一致性的 Fleiss kappa 测量值为自动平板的 0.56，手动平板的 0.60，以及平面 OCTA 与横断面 OCTA 的组合的 0.73（良好一致性）。自动平板的 FA 一致性为中度，手动平板和两种设备的平面 OCTA 与横断面 OCTA 的组合均为良好。
两种设备在 OCTA 上检测 MNV 方面均取得了相当的结果。当评估平面和横断面 OCTA 的组合时，MNV 检测的敏感性和设备之间的一致性最佳。
