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Vasuki Gnana Jothi, Giuseppe Casalino, Usha Chakravarthy; Optical coherence tomography angiography and Contrast imaging comparison in Neo-vascular AMD.. Invest. Ophthalmol. Vis. Sci. 2017;58(8):33.
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© ARVO (1962-2015); The Authors (2016-present)
To compare optical coherence tomography angiography (OCTA) and traditional retinal contrast imaging (Fluorescein Angiography- FA and Indocyanine Green Angiography - ICGA ) findings in unilateral neovascular age related macular degeneration (nAMD).
This was a retrospective cross sectional study in a tertiary referral eye centre. The imaging database was scrutinised to identify patients with nAMD who had OCTA, FA and ICGA. A single observer graded the FA/ICGA images and classified them as nAMD type 1 (sub retinal pigment epithelial new vessels), 2 (subretinal new vessels), 3 (retinal angiomatous proliferation) nAMD or polypoidal choroidal vasculopathy (PCV). To avoid bias OCTA was graded by a separate observer and the presence and location of any neovascular complexes (NC) recorded. The ability of OCT A to pick-up NC was tested by cross tabulations versus FA/ ICG detection and by type of nAMD.The positive and negative predictive values were calculated.
31 patients were included (mean age 77.44 + or - 8.3). 26 patients had both FA and ICGA and 5 patients only FA.On FA/ICGA classification, 7 eyes had type 1, 7 type 2, 4 mixed type, 4 type 3 and 9 PCV. On OCTA NC were visible in 24 eyes (77.4%) and not seen in one eye with type 1, 1 eye with type 2, two eyes with RAP, 2 eyes with PCV. Although NC were visible in eyes with PCV the polyps were not seen in over 50% of cases. With respect to concordance on CNV location, this was achieved in 85.7% of eyes with type 1; 25% of RAP; in 33.3% of PCV; and in none of eyes with subretinal and mixed CNVs.
OCTA showed good sensitivity and specificity (77.4% and 80.6% respectively) as compared to FA/ICGA in the detection of NC. Further improvement in OCTA technology may lead to better diagnosis in the future. Presence of drop out in choriocapillaris on OCTA might be an early indicator of high risk eyes with potential conversion to nAMD.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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