Abstract
Purpose :
Spectral domain optical coherence tomography (SD-OCT) has become the primary imaging modality of detection and monitoring of macular edema in a variety of retinal diseases. The purpose of this study was to compare the detection of intraretinal and subretinal macular fluid with autosegmented en face OCT versus the 25-line raster SD-OCT scan pattern in eyes with branch retinal vein occlusion (BRVO), central retinal vein occlusion (CRVO) and central serous retinopathy (CSR).
Methods :
Retrospective, observational series of patients with BRVO, CRVO, and CSR imaged between November, 2014 and March, 2016. A total of 78 eyes with BRVO, 42 eyes with CRVO, and 37 eyes with CSR were imaged on the same day with both Avanti RTVue XR optical coherence tomography angiography (Optovue Inc., Fremont, CA) with superficial retinal, deep retinal, outer retinal, and choriocapillaris automatic segmentation and Spectralis SD-OCT (Heidelberg Engineering Inc., Heidelberg, Germany) with macular 25-line horizontal raster image acquisition scan patterns. Scans were read by two independent graders and interobserver differences were reconciled by an independent third grader. Sensitivity of fluid detection for the en face scans was determined by using Avanti 304-line raster scans as a gold standard.
Results :
A total of 104 BRVO, 41 CRVO, and 55 CSR en face and 25-line radial SD-OCT scans were interpreted (mean: 1.27 scans/eye). Fifty-one BRVO scans (49.0%), 21 CRVO scans (51.2%), and 33 CSR scans (60.0%) and confirmed fluid on the 304-line SD-OCT. The en face scan pattern had a sensitivity of 94.1% and specificity of 81.1% for BRVO, a sensitivity of 95.2% and specificity of 70.0% for CRVO, and a sensitivity of 78.8% and specificity of 81.8% for CSR. The 25-line scan pattern had a sensitivity of 88.2% and specificity of 100% for BRVO, a sensitivity of 66.7% and specificity of 95.0% for CRVO, and a sensitivity of 93.9% and specificity of 77.3% for CSR.
Conclusions :
The en face SD-OCT scanning protocol alone with automatic segmentation is highly sensitive for detection of macular edema in vein occlusion but not in CSR. The specificity of fluid detection for en face imaging is poor in all three disease states. Positive en face scan findings should be corroborated with additional OCT scan protocols to guide clinical decision making.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.