Diagnostic Characteristics of Polypoidal Choroidal Vasculopathy Based on B-Scan Swept-Source Optical Coherence Tomography Angiography and Its Interrater Agreement Compared With Indocyanine Green Angiography

Fujita, Ai; Kataoka, Keiko; Takeuchi, Jun; Nakano, Yuyako; Horiguchi, Etsuyo; Kaneko, Hiroki; Ito, Yasuki; Terasaki, Hiroko

doi:10.1097/iae.0000000000002760

Cited by 23 publications

(30 citation statements)

References 35 publications

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“…This latter group may be further classified into exudative, hemorrhagic, or mixed. Clinically, the exudation comes in the form of either serous PED, subretinal fluid, serous macular detachment, subretinal lipid exudation, or intraretinal fluid, whereas hemorrhagic PCV presents with subretinal or subretinal pigment epithelium (RPE) hemorrhage [6].…”

Section: Introductionmentioning

confidence: 99%

Polypoidal Choroidal Vasculopathy Diagnosis and Neovascular Activity Evaluation Using Optical Coherence Tomography Angiography

Azar

Vasseur

Lahoud

et al. 2021

BioMed Research International

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Purpose. To examine choroidal neovascularization (CNV) characteristics in patients with exudative age-related macular degeneration (AMD) and polypoidal choroidal vasculopathy (PCV), using swept-source optical coherence tomography angiography (SS-OCTA), and investigate agreement with OCT B-scan, fundus fluorescein angiography (FFA), and indocyanine green angiography (ICGA) by two different examiners. Methods. This is a retrospective multicentric study that involved patients with a history of AMD and PCV. Examiner A, who had access to OCTA, B-scan OCT, FFA, and ICGA imaging, had to differentiate between AMD and PCV, study the activity of AMD using Coscas’ criteria (active vs. quiescent), and categorize PCV subtypes, while examiner B had only access to OCTA. Then, the diagnostic concordance was assessed between both examiners. Results. A total of 27 patients (11 females (40.7%) and 16 males (59.3%), P = 0.231 ) were included in the analysis. Among those, 13 patients presented with neovascular AMD and 14 patients with PCV. There were 92.3% of correct answers regarding appropriate diagnosis and lesion characterization among AMD patients, against 61.5% of correct answers among PCV patients. The overall interrater reliability agreement between examiners, using Cohen’s kappa coefficient ( κ ) was 0.70 (0.5082-0.8916). Disagreement was found with one active AMD misdiagnosed as inactive AMD, three inactive PCV misdiagnosed as inactive AMD, and one inactive PCV misdiagnosed as active AMD. Conclusion. SS-OCTA alone remains limited in some specific phenotypes of PCV, which suggests the ongoing role of B-scan OCT associated with FFA and ICGA in the diagnosis of these conditions.

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Section: Introductionmentioning

confidence: 99%

Polypoidal Choroidal Vasculopathy Diagnosis and Neovascular Activity Evaluation Using Optical Coherence Tomography Angiography

Azar

Vasseur

Lahoud

et al. 2021

BioMed Research International

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“…Optical coherence tomography angiography (OCTA) allows the identification of PCV with a high accuracy and can replace traditional invasive indocyanine green angiography (ICGA) [4,13,14]. In the last years, several studies showed the efficacy of intravitreal injections of vascular endothelial growth factor (VEGF) antagonists for the treatment of PCV [15][16][17][18].…”

Section: Introductionmentioning

confidence: 99%

Structural and Vascular Changes of the Choroid in Polypoidal Choroidal Vasculopathy after Intravitreal Anti-VEGF Therapy

et al. 2021

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Introduction: To identify the changes in vessel density (VD) of choriocapillaris (CC) and in subfoveal choroidal thickness (SFCT) and to evaluate their correlation with functional response after three monthly intravitreal injections of Ranibizumab (loading phase) in patients affected by Polypoidal Choroidal Vasculopathy (PCV). Methods: A total of 30 eyes of 30 PCV patients and 30 eyes of 30 healthy subjects as control group were enrolled in this prospective study. The best corrected visual acuity (BCVA) was measured at baseline and after one month from third intravitreal injections in each patient. The VD of CC was evaluated in macular area by means of Optical Coherence Tomography Angiography (OCTA). Central macular thickness (CMT) and SFCT were analyzed by Enhanced Depth Imaging (EDI)-OCT. Results: The VD of CC showed statistically lower values in PCV patients at baseline respect to after loading phase (LP) and normal eyes (p<0.001). CMT and SFCT revealed a statistically significant reduction after LP (p<0.001). Multiple regression analysis revealed a significant negative correlation between the reduced SFCT, CMT at baseline and the improvement of BCVA after LP (p<0.05). Conclusion: The close relationship between the thinner SFCT and better visual outcome after LP reveals the role of the EDI-OCT assessment of choroid as predictive biomarker of functional response to anti-VEGF therapy. This tool could provide a quantitative evaluation of structural features of choroid avoiding mistakes of evaluation at OCTA.

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“…Cross-sectional SS-OCTA revealed abnormal flow in another 23 of 32 eyes (71.9%) without MNV illustration in en-face SS-OCTA ( Figure 1 B3). The superiority of combining en-face SD-OCTA and cross-sectional SD-OCTA as opposed to en-face SD-OCTA alone in patients with nAMD or PCV has been reported previously [ 28 – 30 ]. Thus, the overall sensitivity of the MNV detection rate in SS-OCTA increased to 94.3% as compared to dye-based angiography.…”

Section: Discussionmentioning

confidence: 74%

The Diagnostic Capability of Swept Source OCT Angiography in Treatment-Naive Exudative Neovascular Age-Related Macular Degeneration

Ahmed¹,

Stattin²,

Haas³

et al. 2021

Journal of Ophthalmology

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Purpose. To evaluate the capability of swept source-optical coherence tomography angiography (SS-OCTA) in the detection and localization of treatment-naive macular neovascularization (MNV) secondary to exudative neovascular age-related macular degeneration (nAMD). Methods. In this prospective, observational case series, 158 eyes of 142 patients were diagnosed with exudative nAMD using fluorescein (FA) and indocyanine green angiography (ICGA) and evaluated by SS-OCTA in a tertiary retina center (Rudolf Foundation Hospital Vienna, Austria). The main outcome measure was the sensitivity of SS-OCTA compared to the standard multimodal imaging approach. Secondary outcome measure was the anatomic analysis of MNV in relation to the retinal pigment epithelium. Results. En-face SS-OCTA confirmed a MNV in 126 eyes (sensitivity: 79.8%), leaving 32 eyes (20.2%) undetected. In 23 of these 32 eyes (71.9%), abnormal flow in cross-sectional SS-OCTA B-scans was identified, giving an overall SS-OCTA sensitivity of 94.3%. Eyes with a pigment epithelium detachment (PED) ≥ 300 μm had a smaller probability for correct MNV detection ( p = 0.015 ). Type 1 MNV showed a trend ( p = 0.051 ) towards smaller probability for the correct detection compared to all other subtypes. Other relevant factors for the nondetection of MNV in SS-OCTA were image artifacts present in 3 of 32 eyes (9.4%). SS-OCTA confirmed the anatomic localization of 93 in 126 MNVs as compared to FA (sensitivity: 73.8%). There was no influence of age, gender, pseudophakia, visual acuity, central foveal thickness, or subfoveal choroidal thickness on the detection rate of MNV. Conclusions. SS-OCTA remains inferior to dye-based angiography in the detection rate of exudative nAMD consistent with type 1 MNV and a PED ≥300 µm. The capability to combine imaging modalities and distinguish the respective MNV subtype improves its diagnostic value.

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Diagnostic Characteristics of Polypoidal Choroidal Vasculopathy Based on B-Scan Swept-Source Optical Coherence Tomography Angiography and Its Interrater Agreement Compared With Indocyanine Green Angiography

Cited by 23 publications

References 35 publications

Polypoidal Choroidal Vasculopathy Diagnosis and Neovascular Activity Evaluation Using Optical Coherence Tomography Angiography

Polypoidal Choroidal Vasculopathy Diagnosis and Neovascular Activity Evaluation Using Optical Coherence Tomography Angiography

Structural and Vascular Changes of the Choroid in Polypoidal Choroidal Vasculopathy after Intravitreal Anti-VEGF Therapy

The Diagnostic Capability of Swept Source OCT Angiography in Treatment-Naive Exudative Neovascular Age-Related Macular Degeneration

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