Agreement of Spectral-Domain OCT with Fluorescein Leakage in Neovascular Age-Related Macular Degeneration
| Autor: | Shamika Gune, Avanti Ghanekar, Lauren Hill, Rahul N. Khurana |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
0303 health sciences
medicine.medical_specialty genetic structures business.industry Spectral domain Macular degeneration medicine.disease eye diseases Confidence interval Lesion 03 medical and health sciences Ophthalmology 0302 clinical medicine Choroidal neovascularization Age related Fluorescein leakage Post-hoc analysis 030221 ophthalmology & optometry medicine sense organs medicine.symptom business 030304 developmental biology |
| Zdroj: | Ophthalmology Retina. 4:1054-1058 |
| ISSN: | 2468-6530 |
| DOI: | 10.1016/j.oret.2020.04.016 |
| Popis: | Purpose To evaluate the agreement between detection of activity of choroidal neovascularization (CNV) in neovascular age-related macular degeneration (AMD) by fundus fluorescein angiography (FFA) and spectral-domain (SD) OCT in the HARBOR study. Most retina specialists rely on OCT to guide treatment decisions in neovascular AMD. However, OCT may not always detect exudative activity. Traditionally, FFA was frequently performed in clinical practice, but its use has diminished due to reliance on OCT. Design Retrospective post hoc analysis of prospective clinical trial (HARBOR; ClinicalTrials.gov identifier, NCT00891735 ). Participants Patients with neovascular AMD in the HARBOR Trial. Methods Baseline to month 24 data from all randomized study eyes in HARBOR with both FFA and SD OCT data were analyzed for (1) evidence of CNV activity on SD OCT (presence of subretinal fluid, intraretinal fluid, and/or cystoid spaces); (2) evidence of CNV activity on FFA identified by the presence of leakage, and (3) cross-tabulation of CNV activity identified by FFA and SD OCT by office visit. Main Outcome Measures The percent agreement between FFA and SD OCT in detecting CNV activity and sensitivity and specificity of SD OCT to detect fluorescein leakage in neovascular AMD using FFA as the reference standard. Results At baseline, 1094 patients (99.9%) had agreement between SD OCT and FFA in detecting CNV activity. By month 24, of the 779 total active cases, the agreement was only 36% (277 cases). By month 24, most cases (n = 452 [58%]) had evidence of CNV activity on SD OCT only, whereas 6% of cases (n = 50) had CNV activity identified by FFA only. At screening and months 3, 6, 12, and 24, 92% to 100% of cases identified by FFA only were occult CNV lesions. Using FFA as the reference standard, the sensitivity and specificity of SD OCT in detecting CNV activity was 91% (95% confidence interval [CI], 84%–99%) and 13% (95% CI, 4%–22%). Conclusions Spectral-domain OCT alone can be relied upon for detecting CNV activity while monitoring eyes with neovascular AMD. However, FFA may still be of value in those with occult lesions that appear quiescent on SD OCT, as this type of lesion may show leakage on FFA. |
| Databáze: | OpenAIRE |
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