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Angela Li, Laura C. Huang, Diana V Do; Trend in the Utilization of Fluorescein Angiography and Optical Coherence Tomography. Invest. Ophthalmol. Vis. Sci. 2019;60(9):1573. doi: https://doi.org/.
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Both fluorescein angiography (FA) and optical coherence tomography (OCT) are widely used to diagnose and monitor pathology of the retina and choroid. FA is considered a more qualitative imaging modality, while OCT allows for more specific and quantitative assessment of all layers of retinal tissue. OCT is also advantageous compared to FA because it is a rapid, non-invasive method to view the macula. We performed a retrospective chart review to evaluate the trend in utilizing FA and OCT in a tertiary ophthalmology department. We hypothesize that for the management of retinal diseases, use of OCT has increased while use of FA has decreased or remained static over the last five years.
All posterior segment OCT and FA images were reviewed from one month (September) in 2013 and 2018. For each clinic day within the month, the proportion of patients who underwent OCT or FA was calculated. Standard one-tailed and two-tailed t-tests assuming equal variances were performed to compare the results.
The number of patients in one month who underwent OCT grew from 831 (2013) to 1,945 (2018). Of all patients who received imaging, the mean percentage of those who had OCT was 59.45% (SD=9.79%) in 2013, compared with 69.97% (SD=8.84%) in 2018. A two-tailed t-test showed that this difference in mean percentages was statistically significant (p<0.002). In addition, the number of patients in one month who had FA showed only a slight increase from 45 (2013) to 67 (2018), despite the 2-fold increase, from 1,280 to 2,542, in the total number of patients who were imaged during that time period. The mean percentage of patients who had FA was 3.11% (SD=2.23%) in 2013 and 2.32% (SD=1.88%) in 2018. A one-tailed t-test demonstrated that the mean percentage of FA in 2018 was not significantly lower than that of 2013 (p<0.120).
Our results are consistent with our hypothesis that over the past 5 years, utilization of posterior segment OCT has increased tremendously while FA utilization has remained relatively stable. In fact, the increase in FA from 2013 and 2018 is modest compared to the 2-fold increase in the total number of patients undergoing imaging. The non-invasive and rapid imaging capabilities of OCT continue to make this imaging modality a useful tool for ophthalmologists, and its use is likely to continue to grow.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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