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Gabriella De Salvo, Gerald Liew, Sara Vaz-Pereira, Pearse Andrew Keane, Adnan Tufail; SENSITIVITY AND SPECIFICITY OF SPECTRAL DOMAIN OPTICAL COHERENCE TOMOGRAPHY IN DETECTING IDIOPATHIC POLYPOIDAL CHOROIDAL VASCULOPATHY. Invest. Ophthalmol. Vis. Sci. 2014;55(13):4049.
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To evaluate the efficacy of spectral-domain optical coherence tomography (SD-OCT) compared to indocyanine green angiography (ICGA) in detecting idiopathic polypoidal choroidal vasculopathy (IPCV) and in differentiating between IPCV and occult choroidal neovascularization (CNV).
SD-OCTs of 51 eyes of 44 consecutive patients who presented with one or more pigment epithelial detachments (PEDs) due to either IPCV or occult CNV were retrospectively reviewed by a grader masked to the final diagnosis. A qualitative analysis based on the following tomographic findings was performed: sharp PED peak, PED notch, hypo-reflective lumen within hyper-reflective lesions adherent to retinal pigment epithelium. The diagnosis based on SD-OCT alone was compared with the final diagnosis made using ICGA and fluorescein angiography. Sensitivity and specificity were calculated.
Among 51 eyes of 44 patients, 37 had an ICGA confirmed diagnosis of IPCV and 14 had occult CNV. SD-OCT based on the features above detected 35/37 true positive IPCV lesions but missed 2 ICGA confirmed lesions (false negatives). SD-OCT correctly excluded 13/14 non-IPCV lesions but misidentified one IPCV lesion (false positive). These data showed a sensitivity of 94.6% and a specificity of 92.9% for the above SD-OCT features in identifying IPCV lesions.
SD -OCT based on the features above allowed for good detection of IPCV and differentiation between IPCV and occult CNV. A careful qualitative analysis of the tomographic findings in patients presenting with PEDs allows ophthalmologists to make a correct diagnosis of IPCV decreasing the need for ICGA and the risks related to this procedure.
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