Department of Ophthalmology, Kim's Eye Hospital, #156 Youngdeungpo-dong 4ga, Youngdeungpo-gu, Seoul, 150-034, South Korea.
BMC Ophthalmol. 2024 Aug 21;24(1):359. doi: 10.1186/s12886-024-03613-4.
To investigate the incidence of and risk factors for failure of detection of active fellow-eye neovascularization on optical coherence tomography(OCT) crosshair scans in patients with unilateral neovascular age-related macular degeneration(AMD).
In this retrospective study, patients who experienced the development of active neovascularization in the fellow eye during the follow-up period were included(n = 75). Cases in which the neovascularization in the fellow eye could be identified solely through crosshair scans were defined as the crosshair scan detection group(n = 63). Cases in which the aforementioned findings could not be identified through crosshair scans but could be identified through raster scans were defined as the raster scan detection group(n = 12). The factors were compared between the two groups. Risk factors related to undetected neovascularization on crosshair scans were additionally identified.
Active fellow-eye neovascularization, was not detected on OCT crosshair scans in 12 cases(16.0%) but was identified on raster scans in all cases. There was a significant difference in the proportion of neovascularization types between the crosshair scan detection group and the raster scan detection group(P = 0.023). Among the 35 fellow-eye neovascularization cases in patients with type 3 macular neovascularization(MNV), 10(28.6%) were not detected on crosshair scans. Multivariate analysis revealed a significantly higher risk for undetectable fellow-eye neovascularization on crosshair scans in patients with type 3 MNV than in those with typical neovascular AMD(P = 0.037,β = 9.600).
Our findings suggest the need for routine OCT raster scans during fellow-eye examinations in patients with unilateral neovascular AMD, particularly when the first-affected eye is diagnosed with type 3 MNV.
研究单侧新生血管性年龄相关性黄斑变性（AMD）患者中，光学相干断层扫描（OCT）十字线扫描检测对活跃性对侧眼新生血管病变的漏诊发生率和漏诊的危险因素。
本回顾性研究纳入了在随访期间对侧眼新生血管化活跃的患者（n=75）。将对侧眼新生血管病变仅通过十字线扫描即可识别的病例定义为十字线扫描检测组（n=63）。将无法通过十字线扫描识别，但可以通过光栅扫描识别的病例定义为光栅扫描检测组（n=12）。比较两组之间的因素。另外，还确定了与十字线扫描漏诊新生血管相关的危险因素。
在 12 例（16.0%）患者中，活跃性对侧眼新生血管化未在 OCT 十字线扫描中检测到，但在光栅扫描中均被识别。十字线扫描检测组和光栅扫描检测组的新生血管病变类型比例有显著差异（P=0.023）。在 35 例 3 型黄斑新生血管（MNV）患者的对侧眼新生血管病变中，有 10 例（28.6%）未在十字线扫描中检测到。多变量分析显示，3 型 MNV 患者的对侧眼新生血管病变在十字线扫描中更难被检测到的风险显著高于典型新生血管 AMD 患者（P=0.037，β=9.600）。
我们的研究结果表明，在单侧新生血管性 AMD 患者中，特别是在第一只受影响的眼被诊断为 3 型 MNV 时，需要对其对侧眼进行常规 OCT 光栅扫描。
