April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
Polypoidal choroidal vasculopathy - is indocyanine green angiography essential for diagnosis?
Author Affiliations & Notes
  • Inês Laíns
    Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
  • João Figueira
    Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
    Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
  • Cláudia Farinha
    Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
  • Maria Luz Cachulo
    Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
    Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
  • Miguel Costa
    Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
  • Ana Rita Santos
    Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
  • Pedro Melo
    Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
  • Rufino Silva
    Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
    Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
  • Footnotes
    Commercial Relationships Inês Laíns, None; João Figueira, Alcon (C), Allergan (C), Bayer Health Care (C), Novartis (C); Cláudia Farinha, None; Maria Luz Cachulo, None; Miguel Costa, None; Ana Rita Santos, None; Pedro Melo, None; Rufino Silva, Alcon (C), Allergan (C), Bayer Health Care (C), Novartis (C), Thea (C)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 3915. doi:https://doi.org/
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      Inês Laíns, João Figueira, Cláudia Farinha, Maria Luz Cachulo, Miguel Costa, Ana Rita Santos, Pedro Melo, Rufino Silva; Polypoidal choroidal vasculopathy - is indocyanine green angiography essential for diagnosis?. Invest. Ophthalmol. Vis. Sci. 2014;55(13):3915. doi: https://doi.org/.

      Download citation file:


      © ARVO (1962-2015); The Authors (2016-present)

      ×
  • Supplements
Abstract

Purpose: To determine the sensitivity and specificity for polypoidal choroidal vasculopathy (PCV) diagnosis without accessing indocyanine-green angiography (ICGA) images. To establish the main optical coherence tomography (OCT) features related with providing a correct diagnosis.

Methods: Local database was accessed by one of the authors, who identified consecutive patients with newly diagnosed PCV or occult choroidal neovascularization (CNV). All medical records were then reviewed and only patients without previous ocular treatments, which had baseline color fundus photographs, OCT, fluorescein angiography (FA) and ICGA images were included. PCV diagnosis was assumed when PCV lesions were identifiable on ICGA. Baseline images were collected and organized by patient, blinding any identifying features. Thereafter, all but ICGA were provided to three other Ophthalmologists. Images’ evaluation was performed independently by each one, according to a standardized database.

Results: One-hundred eyes were included, 53 occult CNV and 47 PCV. 29% had available Spectralis® HRA+OCT, the remaining Cirrus® HD-OCT. Considering diagnosis by graders when at least 2 of them agreed, 32 of the 47 PCV were identified, representing a sensitivity of 68.09% (95% CI 55.88; 80.91) and a specificity of 56.60% (95% CI 42.28; 70.16). Regarding individual results, sensitivity and specificity significantly varied with grader’s experience. The availability of Spectralis® OCT was significantly associated with a higher rate of correct diagnosis (p=0.010). The OCT findings which were most significantly associated with provide a correct PCV diagnosis were the identification of subfoveal (p=0.050) and extrafoveal polypoidal lesions (p=0.001) and of a notch at the margin of serous retinal pigment epithelium detachment (p=0.034). When they were identified, graders always provided a correct diagnosis (positive predictive value of 100% for all).

Conclusions: To our knowledge, this was the first study which evaluated the accuracy of PCV diagnosis without the concomitant use of ICGA. It revealed a good sensitivity and specificity. The graders' experience and the type of available OCT seem to be a determinant factor. Doctors should be trained to identify the OCT features with the higher positive predictive rates.

Keywords: 412 age-related macular degeneration • 550 imaging/image analysis: clinical  
×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×