Department of Ophthalmology, Centre Hospitalier Intercommunal de Creteil University Paris Est Creteil, Creteil, France.
Department of Ophthalmology, IRCCS Hospital San Raffaele, University Vita-Salute, Via Olgettina 60, 20132, Milan, Italy.
Graefes Arch Clin Exp Ophthalmol. 2024 Dec;262(12):3847-3855. doi: 10.1007/s00417-024-06585-9. Epub 2024 Jul 23.
To assess the sensitivity and specificity of the "triple layer sign" (TLS) (retinal pigment epithelium (RPE), neovascular tissue, and Bruch's membrane) on structural optical coherence tomography (OCT) images for the diagnosis of treatment-naïve non-exudative type-1 macular neovascularization (NE-MNV) in age-related macular degeneration (AMD).
Cross-sectional study.
Two masked retinal experts evaluated the presence of the TLS in eyes with NE-MNV and controls with an RPE elevation without exudation due to other causes than NE-MNV in AMD [e.g., medium-large drusen, cuticular drusen, basal laminar deposits (BlamD)].
130 eyes of 98 consecutive patients met the study criteria; 40 eyes of 40 patients satisfied the criteria for being included in the NE-MNV secondary to AMD group (27 females, 13 males, with a mean age of 73.8 ± 8.0 years), and 90 eyes of 58 patients met the criteria to be included in the control group (31 eyes were included in the medium-to-large drusen sub-group, 32 eyes in the cuticular drusen sub-group, and 27 eyes in the BlamD group. The TLS was observed in 39/40 patients with NE-MNV and 8/90 controls. The sensitivity and specificity of the TLS for the diagnosis of NE-MNV were 97% and 91%, respectively.
The TLS on OCT demonstrated high sensitivity and specificity values in detecting treatment-naive type 1 NE-MNV.
评估结构光学相干断层扫描（OCT）图像上“三层征”（RPE、新生血管组织和Bruch 膜）对于诊断未经治疗的年龄相关性黄斑变性（AMD）非渗出型 1 型黄斑新生血管（NE-MNV）的敏感性和特异性。
横断面研究。
两名盲法视网膜专家评估了 NE-MNV 患者和由于 AMD 以外的其他原因（如中等大或大的玻璃膜疣、角膜状玻璃膜疣、基底膜层沉积（BlamD））导致 RPE 抬高但无渗出的对照组中“三层征”的存在。
98 例连续患者中有 130 只眼符合研究标准；40 只眼的 40 例患者符合 AMD 继发 NE-MNV 组的纳入标准（27 名女性，13 名男性，平均年龄 73.8±8.0 岁），90 只眼的 58 例患者符合对照组的纳入标准（31 只眼纳入中等大或大玻璃膜疣亚组，32 只眼纳入角膜状玻璃膜疣亚组，27 只眼纳入 BlamD 组）。在 40 例 NE-MNV 患者中有 39 例和 90 例对照组中有 8 例观察到“三层征”。“三层征”诊断 NE-MNV 的敏感性和特异性分别为 97%和 91%。
OCT 上的“三层征”在检测未经治疗的 1 型 NE-MNV 时具有较高的敏感性和特异性。
