April 2011
Volume 52, Issue 14
ARVO Annual Meeting Abstract  |   April 2011
What Is The Best Method To Measure The Lesions Size For Amd Clinical Trials?
Author Affiliations & Notes
  • Narcisa Ianopol
    Ophthalmology, Railway Clinic Hospital, Iasi, Romania
  • Dante J. Pieramici
    California Retina Consultants, Santa Barbara, California
  • Melvin Rabena
    California Retina Consultants, Santa Barbara, California
  • Jessica Basefsky
    California Retina Consultants, Santa Barbara, California
  • Alessandro Castellarin
    California Retina Consultants, Santa Barbara, California
  • Stephen Couvillon
    California Retina Consultants, Santa Barbara, California
  • Robert Avery
    California Retina Consultants, Santa Barbara, California
  • Footnotes
    Commercial Relationships  Narcisa Ianopol, None; Dante J. Pieramici, None; Melvin Rabena, None; Jessica Basefsky, None; Alessandro Castellarin, None; Stephen Couvillon, None; Robert Avery, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science April 2011, Vol.52, 160. doi:
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      Narcisa Ianopol, Dante J. Pieramici, Melvin Rabena, Jessica Basefsky, Alessandro Castellarin, Stephen Couvillon, Robert Avery; What Is The Best Method To Measure The Lesions Size For Amd Clinical Trials?. Invest. Ophthalmol. Vis. Sci. 2011;52(14):160.

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

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To determine which quantitative method is the best for measurements of the lesion size on fluorescein angiography (FA), in patients with Age Related Macular Degeneration (AMD) .


Patients with neovascular AMD (NAMD), were included at baseline and following treatment with 1.25mg bevacizumab were included. All patients underwent fluorescein angiography prior to and following treatment. The size of the angiographic ally defined lesions was assessed by using a previously reported method developed by the authors, SITE-App, and compared the other quantitative methods previously reported in literature: greatest linear dimension in millimeters - GLD[mm] or pixels - GLD[pix], mouse-delimited lesions area in MPS units - A[MPS], mm2 - A[mm2], total pixels - A[tpix] or white pixels A[wpix]. SITE-App quantifies the retinal lesions area in pixels (white or black), counted inside of standardized circles including the interest lesions. The measurements simplicity, reproducibility and sensitivity were compared for different methods.


The best reproducibility was demonstrated by the methods assessing the lesions size area in pixels of interest (white pixels for NAMD): SITE-App (p=0.49) and A[wpix] (p=0.22). The reproducibility was lower but still good for A[MPS] and A[mm2] (p=0.13). A[tpix] (p=0.01), GLD[pix] (p=0.0003) and GLD[mm] (p=0.0005) were found not reproducible. The highest sensitivity was observed for SITE-App (p1=0.002, p2=0.021) and A[wpix] (p1=0.007, p2=0.02), the two methods being also highly correlated (r1=0,96, r2=0,94).The other methods A[MPS] and A[mm2] were not correlated (R1=1.54±26.1, R2=3.51±17.3) and offered variable responses.


Quantification of retinal lesions in pixels of interest inside zone of standardized areas (SITE-App method) is reproducible, sensitive, easy, fast, automated, and low cost . It may have applications for clinical practice and research.

Clinical Trial:

http://www.clinicaltrials.gov NCT00564148

Keywords: age-related macular degeneration • imaging/image analysis: clinical • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) 

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