Abstract
Purpose :
To assess the quantitative and qualitative agreement between different modes of imaging on an optical coherence tomography (OCT) device that also includes fundus imaging and an infrared image (IR) of geographic atrophy (GA). Our goal was to examine the relationship between the modalities as well as the inter-grader agreement for each modality.
Methods :
Data was obtained and anonymized from a single site which screens all subjects utilizing the Maestro2 (Topcon Healthcare, New Jersey). All data from subjects older than 75 years was used to generate OCT en face images. These were reviewed to identify potential GA cases in 6x6 mm2 images of the macula, where the atrophy was contained within the 6x6 mm2 scan. The full dataset (3D OCT including B-scans, color fundus image, and infrared image) was examined to eliminate hyper-transmission that was not secondary to age-related macular degeneration. Two independant graders outlined areas of hyper and hypo transmission in each of the three images.
Results :
Ten eyes were graded by two graders and the results averaged over all images and all graders. Mean hypo-transmission lesion size was 6.42 mm2 (SD: 4.15) in Color Fundus Photography (CFP), 9.03 mm2 in OCT (SD: 4.32), and 0.72 mm2 in IR (SD: 0.51), indicating that the hypo transmissive regions are better appreciated in en face OCT and poorly appreciated in IR. For hyper transmission, the respective sizes were: 1.13 mm2 (SD: 1.10), 1.32 mm2 (SD: 1.61) and 13.2 mm2 (SD: 11.1). An example lesion is shown in Figure 1. Intergrader agreement was worst for IR, and best for OCT.
Conclusions :
GA appears differently in different modalities, which affects the measurement, and in turn may affect how GA is monitored. A method which takes all available modalities into account, may outperform any single modality.
This abstract was presented at the 2023 ARVO Imaging in the Eye Conference, held in New Orleans, LA, April 21-22, 2023.