Comparison of SD-Optical Coherence TomographyAngiography and Indocyanine Green Angiography in Type1 and 2 Neovascular Age-related Macular Degeneration

Investigative Ophthalmology & Visual Science

article

Reinhard Told¹  Stefan Sacu¹  Alexander Hecht¹  Magdalena Baratsits¹  Katharina Eibenberger¹  Maria E. Kroh¹  Sandra Rezar-Dreindl¹  Ferdinand G. Schlanitz¹  Guenther Weigert¹  Andreas Pollreisz¹  Ursula Schmidt-Erfurth¹ 

[1] Department of Ophthalmology and Optometry, Vienna Clinical Trial Center, Medical University of Vienna

关键词: OCT angiography;    ICGA;    type 1 AMD;    type 2 AMD;    neovascular age-related maculardegeneration;   

DOI  :  10.1167/iovs.17-22902

学科分类：社会科学、人文和艺术（综合）

来源: Association for Research in Vision and Ophthalmology

【 摘 要 】

PURPOSE. The purpose of this study is to compare the ability of spectral domain opticalcoherence tomography angiography (SD-OCTA) and indocyanine green angiography (ICGA)to detect and measure lesion area in patients with type 1 and 2 choroidal neovascularization(CNV).METHODS. Types 1 and 2 neovascular AMD (nAMD) were included in this prospective andobservational case series. ETDRS best-corrected visual acuity (BCVA), ophthalmic examinationwith funduscopy, OCTA (AngioVue), fluorescein angiography (FA), ICGA, and OCT(Spectralis) were performed. CNV measurements were done manually by two experiencedgraders using the systems’ innate region selection tools.RESULTS. Forty eyes of 39 consecutive patients with nAMD were included. Mean age was 77 66.4 years, ETDRS BCVA was 67 6 13 letters, and 11 eyes were treatment na¨ıve. Nineteen CNVlesions were classified as type 1 and 21 as type 2. ICGA was able to identify CNV in all eyes. Bycontrast, OCTA detected CNV in 95% of type 1 and 86% of type 2 nAMD eyes. Mean overallCNV area (CNV-A) was 2.8 6 2.7 mm2 in ICGA and 2.1 6 2.7 mm2 in OCTA. Both lesion typesCNV-A appeared significantly smaller in OCTA compared with ICGA (P < 0.01). Bland-Altmanplot revealed a mean difference (bias) between OCTA and ICGA CNV-A of 0.76 6 1.74 mm2.Intraclass correlation coefficient (ICC) for CNV-A was 0.91 and 0.93 for ICGA and OCTA,respectively. ICGA CNV-A in the four OCTA-negative eyes (median 4.7 mm2) was notsignificantly different from the 36 OCTA-positive eyes (median 1.7 mm2).CONCLUSIONS. Type 1 and 2 CNV-A were significantly smaller in OCTA than in ICGA. OCTA wasgenerally less successful in detecting CNV than ICGA in patients who were included into thisstudy based on FA and OCT. However, OCTA detected all type 1 lesions except for one,indicating that the SD-OCTA signal is limited by detection limits of blood flow velocity ratherthan lesion type. Further efforts are needed pushing the limits of lowest detectable and fastestdistinguishable flow until OCTA can deliver realistic qualitative and quantitative imaging oftype 1 and 2 CNV for diagnosis and monitoring.

【 授权许可】

CC BY|CC BY-NC-ND