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DETECTION OF TREATMENT-NAIVE CHOROIDAL NEOVASCULARIZATION IN AGE-RELATED MACULAR DEGENERATION BY SWEPT SOURCE OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY

Ahmed, Daniel, MD*,†; Stattin, Martin, MD*,†; Graf, Alexandra, PhD; Forster, Julia, MD*; Glittenberg, Carl, MD*,§; Krebs, Ilse, MD*,†; Ansari-Shahrezaei, Siamak, MD*,†,¶

doi: 10.1097/IAE.0000000000001832
Original Study: PDF Only

Purpose: To compare the detection rate of choroidal neovascularization (CNV) in treatment-naive neovascular age-related macular degeneration by swept source optical coherence tomography angiography (SS-OCTA, Topcon's DRI Triton) working at 1,050 nm wavelength versus fluorescence angiography.

Methods: Cross-sectional analysis of 156 eyes (107 neovascular age-related macular degeneration and 49 dry AMD) in 98 patients, previously diagnosed by multimodal imaging using fluorescein (FA) and indocyanine green angiography (Heidelberg's Spectralis) in a tertiary retina center, evaluated by SS-OCTA 4.5 mm × 4.5 mm and 6 mm × 6 mm macular cubes. Main outcome measures were sensitivity and specificity of SS-OCTA in AMD. Potential factors influencing CNV detection rate were analyzed.

Results: Swept source optical coherence tomography angiography detected CNV in 81 of 107 eyes, resulting in a sensitivity of 75.7%. In 49 eyes with dry AMD, no CNV could be identified (specificity 100%). A statistical significance was calculated for nondetection of treatment-naive CNV by SS-OCTA in pigment epithelial detachment over 400 μm (P = 0.0238).

Conclusion: Topcon's SS-OCTA was not able to detect all CNV lesions. Large pigment epithelial detachments were associated with signal loss. Fluorescence angiography still remains the gold standard, but the tested SS-OCTA device can be considered as a feasible additional diagnostic tool in AMD.

Topcon's swept source optical coherence tomography angiography detected choroidal neovascularization lesions in 75.7% of treatment-naive eyes. Large pigment epithelial detachments were associated with choroidal neovascularization signal loss. The authors consider the tested device as a meaningful additional diagnostic tool in neovascular age-related macular degeneration.

*Karl Landsteiner Institute for Retinal Research and Imaging, Rudolf Foundation Hospital, Vienna, Austria;

Department of Ophthalmology, Rudolf Foundation Hospital, Vienna, Austria;

Institute of Medical Statistics, Medical University of Vienna, Vienna, Austria;

§Topcon Europe Medical BV, Capelle aan den IJssel, the Netherlands; and

Department of Ophthalmology, Medical University of Graz, Graz, Austria.

Reprint requests: Siamak Ansari-Shahrezaei, MD, Department of Ophthalmology, Rudolf Foundation Hospital, Juchgasse 25, 1030 Vienna, Austria; e-mail: siamak.ansari-shahrezaei@wienkav.at

All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. C. Glittenberg is a Senior Clinical Advisor of Topcon Europe and as such has a proprietary interest in this work. The authors have not published or submitted any related paper from this study. Neither was the paper presented at a meeting. None of the remaining authors has any financial/conflicting interests to disclose.

D. Ahmed and M. Stattin contributed equally to the content of this article.

OCTA images were captured by a beta version of Topcon's DRI Triton Swept Source OCTA.

© 2018 by Ophthalmic Communications Society, Inc.