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DIAGNOSIS OF TYPE 3 NEOVASCULARIZATION BASED ON OPTICAL COHERENCE TOMOGRAPHY IMAGES

Kim, Jae Hui MD; Chang, Young Suk MD; Kim, Jong Woo MD; Lee, Tae Gon MD; Kim, Hyoung Seok MD

doi: 10.1097/IAE.0000000000000932
Original Study

Purpose: To evaluate the concordance of an optical coherence tomography (OCT)–based diagnosis of Type 3 neovascularization and an indocyanine green angiography (ICGA)–based diagnosis in neovascular age-related macular degeneration (AMD).

Methods: This observational case series includes 263 eyes from 263 patients who were diagnosed with treatment-naive neovascular AMD. Patients exhibiting at least three of the following OCT features were diagnosed with Type 3 neovascularization: subfoveal choroidal thickness <200 μm, presence of intraretinal fluid accumulation, absence of subretinal fluid, gently-sloping dome-shaped retinal pigment epithelial detachment or trapezoid-shaped retinal pigment epithelial detachment without an obvious peak, and intraretinal mass lesion. The incidence of cases exhibiting three or more OCT features was compared among different subtypes of neovascular AMD. Additionally, the concordance of OCT-based diagnosis and ICGA-based diagnosis was evaluated.

Results: Three or more OCT features were noted in 8 of 82 (9.8%) eyes with typical neovascular AMD, 4 of 147 (2.7%) eyes with polypoidal choroidal vasculopathy, and 30 of 34 (88.2%) eyes with Type 3 neovascularization, respectively. The incidence was significantly greater in Type 3 neovascularization than in the other subtypes of neovascular AMD (P < 0.001). Of patients diagnosed with Type 3 neovascularization using ICGA-based methods, 88.2% were also diagnosed with Type 3 neovascularization using OCT-based methods. Only 5.2% of patients diagnosed with other subtypes of neovascular AMD using ICGA-based methods were diagnosed with Type 3 neovascularization using OCT-based methods.

Conclusion: Optical coherence tomography–based diagnosis of Type 3 neovascularization showed relatively high concordance compared with ICGA-based diagnosis. This method may be useful in clinical practice.

Optical coherence tomography–based diagnosis of Type 3 neovascularization showed relatively high concordance compared with indocyanine green angiography–based diagnosis. This result suggests that the optical coherence tomography–based diagnosis may be useful in clinical practice. This method may also be useful in subgroup analysis for Type 3 neovascularization in clinical studies.

*Department of Ophthalmology, Kim's Eye Hospital, Konyang University College of Medicine, Seoul, South Korea; and

Department of Ophthalmology, Konyang University College of Medicine, Daejeon, South Korea.

Reprint requests: Jae Hui Kim, MD, Department of Ophthalmology, Kim's Eye Hospital, #156 Youngdeungpo-dong 4ga, Youngdeungpo-gu, Seoul, 150-034, South Korea; e-mail: kimoph@gmail.com

Supported by Kim's Eye Hospital Research Center.

None of the authors have any conflicting interests to disclose.

© 2016 by Ophthalmic Communications Society, Inc.