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G. Lale Lacroix, A. M. Fea, R. Rigault de la Longrais, F. Fronticelli, G. Strani, F. Grignolo; OCT and Fluoroangiographic Analysis of AMD Lesions in Virgin and Post-PDT Patients. Invest. Ophthalmol. Vis. Sci. 2007;48(13):5098.
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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.
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.
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.
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.
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