Abstract
Abstract: :
Purpose:The advent of Photo–Dynamic Therapy (PDT) has led to a large increase in Fundus Fluoroscein Angiography (FFA) requests to screen patients for Choroidal Neovascularization (CNV). FFA is invasive, has a small risk and is time consuming. Optical Coherence Tomography (OCT) is non–contact, non–invasive and quick. We aimed to address if OCT can be used to screen patients by correlating the diagnostic accuracy of OCT with the gold standard FFA in the diagnosis of CNV. Methods:A consecutive series of patients suspected of CNV underwent OCT and stereo FFA images. Images were retrospectively reviewed by 2 independent observers, one assessing OCT, the other FFA, each blind to the other’s grading. OCT images were initially assessed in isolation and then reviewed with colour stereo photos. The main outcome measures were categorisation of features. Results:Fifty–two eyes of 39 patients (mean age 71.1, range 30–86, 18 males) had FFA and OCT images. The diagnoses on FFA were: 22 eyes classic CNV, 2 eyes occult CNV, 4 eyes Pigment Epithelial Detachment (PED) and 9 eyes Geographical Atrophy (GA). Analysis of the corresponding OCT images identified 16 eyes (72.7%) with classic CNV, 1 eye (50%) with occult CNV, 4 eyes (100%) with PED and 6 eyes (66.7%) with GA. The OCT correctly identified 24 of 28 (85.7%) non–CNVs. When stereo colour fundus and OCT images were viewed together, they identified 21 eyes (95.5%) with classic CNV and 25 of 28 (89.3%) non–CNVs. Conclusions:OCT diagnoses CNV with a sensitivity of 72.7% and a specificity of 85.7%. With the addition of stereo colour fundus imaging sensitivity is 91.7% and specificity is 89.3%.
Keywords: retina • imaging/image analysis: clinical • choroid: neovascularization