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DISTINGUISHING POLYPOIDAL CHOROIDAL VASCULOPATHY FROM TYPICAL NEOVASCULAR AGE-RELATED MACULAR DEGENERATION BASED ON SPECTRAL DOMAIN OPTICAL COHERENCE TOMOGRAPHY

Liu, Ran MD; Li, Jiaqing MD, PHD; Li, Zijing MD; Yu, Shanshan MD; Yang, Yu MD; Yan, Hong MD, PHD; Zeng, Jing MD; Tang, Shibo MD, PHD; Ding, Xiaoyan MD, PHD

doi: 10.1097/IAE.0000000000000794
Original Study

Purpose: To investigate the sensitivity and specificity of spectral domain optical coherence tomography in distinguishing polypoidal choroidal vasculopathy (PCV) from typical neovascular age-related macular degeneration (nAMD).

Methods: One hundred and eighty-eight eyes in 156 patients with active PCV or typical nAMD were enrolled prospectively. Three spectral domain optical coherence tomography manifestations, pigment epithelium detachment, double-layer sign, and thumb-like polyps were estimated in all the eyes. A diagnostic test to differentiate PCV from nAMD based on spectral domain optical coherence tomography was performed. Furthermore, the sensitivity and specificity was validated in a retrospective series of patients.

Results: Pigment epithelium detachment, double-layer sign, and thumb-like polyps were more common in PCV eyes than in nAMD eyes. When the cutoff point was set as at least 2 positive signs out of 3 in the diagnostic test, the sensitivity was 89.4% and specificity was 85.3%. The results of the validation test further confirmed the strategy, with satisfying sensitivity (87.5%) and specificity (86.2%).

Conclusion: Spectral domain optical coherence tomography is sensitive and specific in distinguishing PCV from nAMD. From these results, the presence of at least two out three signs (pigment epithelium detachment, double-layer sign, and thumb-like polyps) indicates a positive test and is therefore suggested to be the screening strategy for PCV.

Three SD-OCT signs, namely pigment epithelium detachment, double-layer sign, and thumb-like polyps, were more common in polypoidal choroidal vasculopathy than in typical neovascular age-related macular degeneration. A sensitivity and specificity was calculated to distinguish polypoidal choroidal vasculopathy from neovascular age-related macular degeneration based on SD-OCT. The results suggested that the presence of at least two of the three signs could be considered as the screening strategy for polypoidal choroidal vasculopathy.

Vitreoretinal Department, State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangzhou, China.

Reprint requests: Xiaoyan Ding, MD, PhD, Vitreoretinal Department, State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, 54, Xianlie S Road, Yuexiu, Guangzhou, Guangdong, P.R.China; e-mail: dingxy75@gmail.com

Supported by the Fundamental Research Funds of State Key Laboratory of Ophthalmology and National Natural Science Foundation of China 81470645.

None of the authors have any financial/conflicting interests to disclose.

R. Liu and J. Li are contributed equally.

© 2016 by Ophthalmic Communications Society, Inc.