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OPTICAL COHERENCE TOMOGRAPHY, FLUORESCEIN ANGIOGRAPHY, AND DIAGNOSIS OF CHOROIDAL NEOVASCULARIZATION IN AGE-RELATED MACULAR DEGENERATION

Gualino, Vincent, MD*; Tadayoni, Ramin, MD, PhD*; Cohen, Salomon Yves, MD, PhD; Erginay, Ali, MD*; Fajnkuchen, Franck, MD; Haouchine, Belkacem, MD*; Krivosic, Valérie, MD*; Quentel, Gabriel, MD; Vicaut, Eric, MD, PhD; Gaudric, Alain, MD, PhD*

doi: 10.1097/IAE.0000000000002220
Original Study: PDF Only

Purpose: To determine the sensitivity and specificity of different retinal imaging combinations for the diagnosis of choroidal neovascularization (CNV) in age-related macular degeneration.

Methods: Patients aged 50 years or older referred for suspicious recent-onset CNV related to age-related macular degeneration were prospectively included for 6 months. Data recorded included color fundus photographs (CFPs), spectral domain optical coherence tomography (SD-OCT), and fluorescein angiography (FA) images. Five retina specialists randomly interpreted SD-OCT combined with CFP, and then FA combined with CFP. The reference diagnosis of CNV was based on the agreement of two readers in the interpretation of the SD-OCT + FA + CFP combination.

Results: One hundred and forty-eight patients (148 eyes) were included. For the diagnosis of CNV, the sensitivity of both SD-OCT + CFP and FA + CFP was of 90.9%. Type 2 CNV was diagnosed in 98% to 100% of cases with SD-OCT + CFP or FA + CFP, whereas Type 1 CNV was diagnosed in 82.9% of cases with SD-OCT + CFP and 81.6% with FA + CFP.

Conclusion: When used as a first diagnostic test, SD-OCT combined with CFP had sensitivity and specificity similar to those of FA combined with CFP, for the diagnosis of CNV in age-related macular degeneration. This shows the increasingly important role of SD-OCT as a first-line test in the diagnosis of CNV.

This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

In a prospective study, spectral domain optical coherence tomography and fluorescein angiography, combined with color fundus photograph used as a first diagnostic test in patients aged 50 years or older, had a similar sensitivity and specificity for the diagnosis of choroidal neovascularization in age-related macular degeneration.

*Ophthalmology Department, AP-HP, Hôpital Lariboisière, Université Paris Diderot, Sorbonne Paris Cité, France;

Centre d'Imagerie et de Laser, Paris, France; and

Clinical Research Unit, AP-HP, Hôpital Lariboisière, Université Paris Diderot, Sorbonne Paris Cité, France.

Reprint requests: Ramin Tadayoni, MD, PhD, Lariboisière Hospital, 2 rue Ambroise Paré, 75010 Paris, France; e-mail: ramin.tadayoni@aphp.fr

Public Financial Support: Département de la Recherche Clinique et du Développement (DRCD), AP-HP, Paris, France

None of the authors has any conflicting interests to disclose.

© 2018 by Ophthalmic Communications Society, Inc.