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C. Luiselli, F. Bottoni, A. Giani, M. Cereda, S. Luccarelli, G. Staurenghi; Detection of Choroidal Neovascularization Activity Using Spectral-Domain Optical Coherence Tomography. Invest. Ophthalmol. Vis. Sci. 2008;49(13):2229.
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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 choroidal neovascularizarion (CNV)
Retrospective analysis of SD-OCT (HRA+OCT Spectralis, Heidelberg Engineering GmbH, Heidelberg, Germany ) and simultaneous FA images of 40 consecutive patients (40 eyes) with diagnosis of choroidal neovascularization in age-related maculopathy. FA images were analyzed by expert retinal specialists (GS, FB) to identify activity of the lesions (gold standard). Analysis of SD-OCT were performed by masked expert operators (AG, MC, SL) to identify characteristics associated with CNV angiographic activity. Previously known features such as intraretinal edema, retinal pigment epithelium serous/haemorragic detachment, neurosensory serous detachment were evaluated. Additionally, new characteristics peculiar to SD-OCT such as low lesion reflectivity, vanished boundaries, and intraretinal fine hyperreflective spots were examined.
Activity of the choroidal neovascolarization was recorded by FA in 31 out of 40 eyes (77.5%) as compared with 30 out of 40 eyes (75%) by OCT.Sensitivity and specificity of OCT evaluation as compared with the gold standard (FA) was respectively 0.84 and 0.55.
HRA+OCT Spectralis, with high resolution and real-time mean image elaboration, may enhance the visualization of new CNVs characteristics, such as the low internal reflectivity. These new OCT features seem to be associated with activity of the lesions as detected by fluorescein angiography. The high sensitivity on neovascular activity expressed by these OCT features may be useful in clinical practice reducing the need of angiographies for treatment decisions.
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