Retinal imaging including optical coherence tomography angiography for detecting active choroidal neovascularization in pseudoxanthoma elasticum
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Retinal imaging including optical coherence tomography angiography for detecting active choroidal neovascularization in pseudoxanthoma elasticum. / Birtel, Johannes; Lindner, Moritz; Mishra, Divyansh K; Müller, Philipp L; Hendig, Doris; Herrmann, Philipp; Holz, Frank G; Fleckenstein, Monika; Gliem, Martin; Charbel Issa, Peter.
In: CLIN EXP OPHTHALMOL, Vol. 47, No. 2, 03.2019, p. 240-249.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Retinal imaging including optical coherence tomography angiography for detecting active choroidal neovascularization in pseudoxanthoma elasticum
AU - Birtel, Johannes
AU - Lindner, Moritz
AU - Mishra, Divyansh K
AU - Müller, Philipp L
AU - Hendig, Doris
AU - Herrmann, Philipp
AU - Holz, Frank G
AU - Fleckenstein, Monika
AU - Gliem, Martin
AU - Charbel Issa, Peter
N1 - © 2018 Royal Australian and New Zealand College of Ophthalmologists.
PY - 2019/3
Y1 - 2019/3
N2 - IMPORTANCE: The diagnostic accuracy of different retinal imaging modalities to detect active choroidal neovascularization (CNV) in pseudoxanthoma elasticum (PXE) is essential to enable a correct diagnosis but is currently poorly understood.BACKGROUND: Optical coherence tomography (OCT), fluorescein angiography (FA) and OCT angiography (OCT-A) are employed in daily practice, but a systematic comparison of these imaging techniques is lacking.DESIGN: Retrospective, observational study.PARTICIPANTS: Twenty patients (31 eyes) with PXE.METHODS: OCT, FA and OCT-A imaging was performed in each eye and graded separately by independent readers.MAIN OUTCOME MEASURES: Diagnostic accuracy, sensitivity and specificity to detect CNV-activity of each modality and longitudinal change of CNV size measured by OCT-A.RESULTS: OCT showed the highest diagnostic accuracy (kappa = 0.57) in comparison to OCT-A or FA (kappa = 0.39 and 0.37, respectively). OCT-A, OCT and FA showed a diagnostic sensitivity of 0.9, 0.85 and 0.6, and a diagnostic specificity of 0.45, 0.72 and 0.82, respectively. Evaluation of longitudinal OCT recordings (24 eyes) resulted in optimal sensitivity and specificity (kappa = 1.0). Although median CNV size assessed using OCT-A remained stable on longitudinal measures of seven eyes, two eyes showed a distinct increase over time despite anti-vascular endothelial growth factor treatment.CONCLUSIONS AND RELEVANCE: The systematic use of OCT, FA and OCT-A imaging can facilitate the diagnostic accuracy for detection and follow-up of CNV activity in PXE. While structural OCT is of high value, especially when longitudinal follow-up images are available, FA and OCT-A data might contribute to diagnostic accuracy in more complex cases.
AB - IMPORTANCE: The diagnostic accuracy of different retinal imaging modalities to detect active choroidal neovascularization (CNV) in pseudoxanthoma elasticum (PXE) is essential to enable a correct diagnosis but is currently poorly understood.BACKGROUND: Optical coherence tomography (OCT), fluorescein angiography (FA) and OCT angiography (OCT-A) are employed in daily practice, but a systematic comparison of these imaging techniques is lacking.DESIGN: Retrospective, observational study.PARTICIPANTS: Twenty patients (31 eyes) with PXE.METHODS: OCT, FA and OCT-A imaging was performed in each eye and graded separately by independent readers.MAIN OUTCOME MEASURES: Diagnostic accuracy, sensitivity and specificity to detect CNV-activity of each modality and longitudinal change of CNV size measured by OCT-A.RESULTS: OCT showed the highest diagnostic accuracy (kappa = 0.57) in comparison to OCT-A or FA (kappa = 0.39 and 0.37, respectively). OCT-A, OCT and FA showed a diagnostic sensitivity of 0.9, 0.85 and 0.6, and a diagnostic specificity of 0.45, 0.72 and 0.82, respectively. Evaluation of longitudinal OCT recordings (24 eyes) resulted in optimal sensitivity and specificity (kappa = 1.0). Although median CNV size assessed using OCT-A remained stable on longitudinal measures of seven eyes, two eyes showed a distinct increase over time despite anti-vascular endothelial growth factor treatment.CONCLUSIONS AND RELEVANCE: The systematic use of OCT, FA and OCT-A imaging can facilitate the diagnostic accuracy for detection and follow-up of CNV activity in PXE. While structural OCT is of high value, especially when longitudinal follow-up images are available, FA and OCT-A data might contribute to diagnostic accuracy in more complex cases.
KW - Adult
KW - Aged
KW - Choroidal Neovascularization/diagnosis
KW - Female
KW - Fluorescein Angiography
KW - Follow-Up Studies
KW - Humans
KW - Male
KW - Middle Aged
KW - Pseudoxanthoma Elasticum/diagnosis
KW - Reproducibility of Results
KW - Retrospective Studies
KW - Sensitivity and Specificity
KW - Tomography, Optical Coherence
KW - Visual Acuity/physiology
U2 - 10.1111/ceo.13385
DO - 10.1111/ceo.13385
M3 - SCORING: Journal article
C2 - 30168640
VL - 47
SP - 240
EP - 249
JO - CLIN EXP OPHTHALMOL
JF - CLIN EXP OPHTHALMOL
SN - 1442-6404
IS - 2
ER -
