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C. Luiselli, A. Giani, P. A. Salvetti, F. Bottoni, M. Cigada, G. Staurenghi; Detection of Classic Choroidal Neovascularization Activity Using Spectral-Domain Optical Coherence Tomography. Invest. Ophthalmol. Vis. Sci. 2009;50(13):5244.
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To study the correlation between fluorescein angiography (FA) and spectral-domain optical coherence tomography (SD-OCT) findings in the diagnosis of activity of classic choroidal neovascularization (CNV).
Retrospective analysis of SD-OCT (HRA+OCT Spectralis, Heidelberg Engineering GmbH, Heidelberg, Germany) and simultaneous FA images of 55 consecutive patients (55 eyes) with diagnosis of classic choroidal neovascularization in age-related maculopathy. FA images were analyzed by expert retinal specialist to identify activity of the lesions. Analysis of SD-OCT were performed by masked expert operators to identify characteristics associated with CNV angiographic activity. Previously known features such as intraretinal edema, retinal pigment epithelium detachment, neurosensory detachment were evaluated. Additionally, new characteristics peculiar to SD-OCT such as low lesion optical reflectivity, undefined boundaries, and intraretinal small hyperreflective spots were examined.
The study revealed that there was a substantial agreement between angiographical activity of the lesions and the low optical reflectivity (k=0.78); also the presence of neuroepithelium detachment showed an high level of concordance (k=0.70), while the undefined boundaries of the lesions in the OCT images had only a moderate concordance with the angiographical activity.Small hyperreflective spots, retinal pigment epithelium detachment and intraretinal edema did not show any agreement with activity of the lesions (k=0.37, k=0.21 and -0.18 respectively).
SD-OCT, thanks to high resolution combined with the real-time averaging that reduces the speckle noise, enhance the visualization of new CNVs characteristics, such as the low lesion reflectivity, that seem to be associated with activity of the lesions as detected by fluorescein angiography. These findings may be useful in clinical practice, to reduce the need of angiographies for treatment decisions and follow up.
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