Fluoreszein‑, Indocyaningrün- und optische Kohärenztomographie-Angiographie bei Patienten mit nativer exsudativer altersabhängiger Makuladegeneration

TY - JOUR

T1 - Fluoreszein‑, Indocyaningrün- und optische Kohärenztomographie-Angiographie bei Patienten mit nativer exsudativer altersabhängiger Makuladegeneration

AU - Pauleikhoff, L J B

AU - Blobner, K

AU - Wehrmann, K

AU - Feucht, N

AU - Lohmann, C P

AU - Maier, M

PY - 2018/7

Y1 - 2018/7

N2 - INTRODUCTION: The newly developed optical coherence tomography angiography (OCT-A) has provided new means to depict the vascular plexus in neovascular age-related macular degeneration (nAMD). If these images are to be used as a basis for therapeutic decisions, it is of vital importance to classify choroidal neovascularization (CNV) as either classical or occult. This study aimed at comparing the findings in OCT-A imaging of CNV with the traditional multimodal imaging through fluorescein angiography (FLA) and indocyanine green angiography (ICGA).METHODS: For this investigation 13 eyes from 13 patients with CNV on the basis of untreated nAMD were studied using FLA, ICGA, spectral domain OCT and OCT-A. All CNV were classified on the basis of SD-OCT and OCT-A images by two independent raters. Thereafter FLA and ICGA images were analyzed to set the gold standard for the classification and the ratings were compared to the previous SD-OCT and OCT-A results.RESULTS: 88% of eyes were correctly classified as either classical or occult CNV on the basis of SD-OCT and OCT-A images. Based on the CNV subgroups, 93% of classical CNV were identified using OCT-A images. In contrast occult CNV was correctly classified in 83% of patients. The interrater agreement was 77%. In general it was noted that the more the retina was pathologically altered, e. g. by edema or vascular pigment epithelium detachment, the harder it became to correctly classify the CNV.DISCUSSION: These results show that OCT-A can be used as an interesting addition in the diagnosis of CNV in nAMD. All CNV could be visualized using OCT-A and especially classical CNV could be clearly recognized in most cases. In contrast occult CNV could be identified in slightly fewer cases.

AB - INTRODUCTION: The newly developed optical coherence tomography angiography (OCT-A) has provided new means to depict the vascular plexus in neovascular age-related macular degeneration (nAMD). If these images are to be used as a basis for therapeutic decisions, it is of vital importance to classify choroidal neovascularization (CNV) as either classical or occult. This study aimed at comparing the findings in OCT-A imaging of CNV with the traditional multimodal imaging through fluorescein angiography (FLA) and indocyanine green angiography (ICGA).METHODS: For this investigation 13 eyes from 13 patients with CNV on the basis of untreated nAMD were studied using FLA, ICGA, spectral domain OCT and OCT-A. All CNV were classified on the basis of SD-OCT and OCT-A images by two independent raters. Thereafter FLA and ICGA images were analyzed to set the gold standard for the classification and the ratings were compared to the previous SD-OCT and OCT-A results.RESULTS: 88% of eyes were correctly classified as either classical or occult CNV on the basis of SD-OCT and OCT-A images. Based on the CNV subgroups, 93% of classical CNV were identified using OCT-A images. In contrast occult CNV was correctly classified in 83% of patients. The interrater agreement was 77%. In general it was noted that the more the retina was pathologically altered, e. g. by edema or vascular pigment epithelium detachment, the harder it became to correctly classify the CNV.DISCUSSION: These results show that OCT-A can be used as an interesting addition in the diagnosis of CNV in nAMD. All CNV could be visualized using OCT-A and especially classical CNV could be clearly recognized in most cases. In contrast occult CNV could be identified in slightly fewer cases.

KW - Choroidal Neovascularization

KW - Fluorescein

KW - Fluorescein Angiography

KW - Humans

KW - Indocyanine Green

KW - Macular Degeneration

KW - Tomography, Optical Coherence

U2 - 10.1007/s00347-017-0537-4

DO - 10.1007/s00347-017-0537-4

M3 - SCORING: Zeitschriftenaufsatz

C2 - 28707091

VL - 115

SP - 579

EP - 584

JO - OPHTHALMOLOGE

JF - OPHTHALMOLOGE

SN - 0941-293X

IS - 7

ER -