光学相干断层扫描特征可用于识别息肉样脉络膜血管病变治疗后的完全息肉样回归。

Optical Coherence Tomography Features for Identifying Posttreatment Complete Polypoidal Regression in Polypoidal Choroidal Vasculopathy.

机构信息

Department of Ophthalmology, Retina Division, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.

Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.

出版信息

Asia Pac J Ophthalmol (Phila). 2022 Sep 1;11(5):408-416. doi: 10.1097/APO.0000000000000551.

DOI:10.1097/APO.0000000000000551

PMID:36179334

Abstract

PURPOSE

To determine accuracy and relative risk (RR) of posttreatment optical coherence tomography (OCT) features in identifying complete or incomplete polypoidal regression in polypoidal choroidal vasculopathy (PCV).

DESIGN

Validity analysis.

METHODS

Treatment-naive PCV eyes undergoing OCT and indocyanine green angiography (ICGA) at baseline and posttreatment were included. Two graders confirmed diagnosis and identified posttreatment complete or incomplete regression on ICGA. Two other graders classified OCT characteristics of pigment epithelial detachment (PED) (polypoidal lesion) based on 5 prespecified features: "A," no PED; "B," PED with internal homogeneous reflectivity with predominant "BUN" (blended retinal pigment epithelium with underlying structure) sign; "C," PED with internal homogeneous reflectivity with minimal "BUN"; "D," heterogeneous PED; and "E," PED with hyporeflectivity.

RESULTS

Among 130 polypoidal lesions (65 pretreatment and 65 posttreatment) of 39 PCV eyes (39 patients; 54% female; mean age±SD: 64.6±8.2), all pretreatment lesions showed feature D on OCT. Posttreatment lesions with complete regression (31 lesions) showed OCT features A, B, C, D, and E in 32%, 45%, 13%, 10%, and 0%, respectively. Posttreatment lesions with incomplete regression (34 lesions) showed OCT features A, B, C, D, and E in 0%, 6%, 15%, 79%, and 0%, respectively. Presence of either feature A or B had highest accuracy (86%; 95% confidence interval: 75%-93%); 77% sensitivity; 94% specificity; RR 5.0 (3.5-7.1, P<0.001) for complete regression. Presence of feature D had highest accuracy (85%; 95% confidence interval: 74%-92%); 79% sensitivity; 90% specificity; RR 4.6 (3.0-6.9, P<0.001) for incomplete regression.

CONCLUSIONS

Without ICGA, OCT features could provide high accuracy in identifying posttreatment complete or incomplete polypoidal regression in PCV.

摘要

目的

确定治疗后光学相干断层扫描（OCT）特征在识别息肉样脉络膜血管病变（PCV）中完全或不完全息肉样回归的准确性和相对风险（RR）。

设计

有效性分析。

方法

纳入基线和治疗后接受 OCT 和吲哚青绿血管造影（ICGA）的未经治疗的 PCV 眼。两名分级员确认诊断，并在 ICGA 上确定治疗后的完全或不完全消退。另外两名分级员根据 5 个预设特征对色素上皮脱离（PED）（息肉样病变）的 OCT 特征进行分类：“A”，无 PED；“B”，PED 内部均匀反射，主要为“BUN”（混合视网膜色素上皮与下层结构）征；“C”，PED 内部均匀反射，最小“BUN”；“D”，异质性 PED；和“E”，PED 低反射。

结果

在 39 例 PCV 眼（39 例患者；54%为女性；平均年龄±标准差：64.6±8.2）的 130 个息肉样病变（65 个预处理和 65 个治疗后）中，所有预处理病变在 OCT 上均显示特征 D。完全消退的治疗后病变（31 个病变）分别显示 OCT 特征 A、B、C、D 和 E 的比例分别为 32%、45%、13%、10%和 0%。不完全消退的治疗后病变（34 个病变）分别显示 OCT 特征 A、B、C、D 和 E 的比例分别为 0%、6%、15%、79%和 0%。存在特征 A 或 B 的存在具有最高的准确性（86%；95%置信区间：75%-93%）；77%的敏感性；94%的特异性；RR 5.0（3.5-7.1，P<0.001）用于完全消退。存在特征 D 具有最高的准确性（85%；95%置信区间：74%-92%）；79%的敏感性；90%的特异性；RR 4.6（3.0-6.9，P<0.001）用于不完全消退。