Abstract
Purpose::
Age-related macular degeneration (ARMD) treatment is mainly based on fluorangiographic (FAG) signs of activity. FAG inter and intra-observer agreement is relatively poor and the sensitivity and specificity of FAG is lower than OCT. The aim of the study was to evaluate the inter-observer agreement of FAG and OCT and the concordance in the activity evaluation between FAG, ICG and OCT in patients without treatment or who underwent PDT.
Methods::
98 AMD patients (119 eyes) underwent a complete ophthalmic examination, FAG, ICG and OCT. 73 eyes underwent PDT according to the TAP guidelines. According to the number of PDT treatments, patients were divided in 5 groups (0: no treatment; 4: 4 treatments). FAG, ICG and OCT were evaluated by two experienced and independent observers unaware of the clinical findings.
Results::
The mean FAG inter-observer agreement was 76.1%, being higher (89,1%) in group 0 and lowest (63,3%). The mean OCT inter-observer agreement was 97%, being higher (100%) in group 0 and lowest (93,3%). The mean ICG inter-observer agreement was 68.3%, being higher (83,2%) in group 0 and lowest (61,3%). Mean FAG and ICG agreement on activity was 70,8%, being higher in group 4 (80%) and lowest in group 2 (60,1%). Mean FAG and OCT agreement on activity was 76,5%, being higher in group 4 (85,9%) and lowest in group 2 (68,6%). Most of the non-agreement between FAG and OCT was due to patients with intra-retinal fluid.
Conclusions::
FAG and OCT have a relatively good inter-observer agreement. The agreement between different observers is lower after PDT treatment and might influence the treatment strategies. OCT might be considered in such cases.
Keywords: age-related macular degeneration