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Clinical science
Evaluation of the clinical utility of optical coherence tomography angiography in age-related macular degeneration
  1. Melina Cavichini1,2,
  2. Kunny C Dans1,
  3. Mahima Jhingan1,3,
  4. Manuel J Amador-Patarroyo1,4,
  5. Shyamanga Borooah5,6,
  6. Dirk-Uwe Bartsch1,
  7. Eric Nudleman1,
  8. William R Freeman7
  1. 1 Jacobs Retina Center, Shiley Eye Institute, University of California San Diego, La Jolla, California, USA
  2. 2 Ophthalmology, Faculdade De Medicina Do ABC, Santo Andre, Brazil
  3. 3 Aravind Eye Hospital, Madurai, India
  4. 4 Ophthalmology, Escuela Superior De Oftalmologia, Instituto Barraquer De America, Bogota, Colombia
  5. 5 Ophthalmology, University of California San Diego, La Jolla, California, USA
  6. 6 Center for Clinical Brain Sciences, School of Clinical Sciences, the University of Edinburgh, Edinburgh, Scotland, UK
  7. 7 Jacobs Retina Center, Shiley Eye, UCSD, La Jolla, California, USA
  1. Correspondence to William R Freeman, Jacobs Retina Center, Shiley Eye Institute, University of California San Diego, 9415 Campus Point Drive 0946, La Jolla, CA 92093, USA; wrfreeman{at}health.ucsd.edu

Abstract

Background/Aims To evaluate the ability of optical coherence tomography angiography (OCTA) to identify the presence or absence of choroidal neovascularisation (CNV) and CNV activity in age-related macular degeneration (AMD).

Methods Clinical parameters, fundus fluorescein angiogram and spectral-domain optical coherence tomography (SD-OCT) were used as the gold standard to determine disease activity. OCTA imaging was performed on the same day and was graded by two masked retina specialists for the presence or absence of CNV. Traditional multimodal imaging and OCTA findings were compared.

Results One hundred and fifty-two eyes of 106 patients with AMD were retrospectively reviewed. Of these, 59 eyes had wet AMD and 93 had dry AMD with high-risk drusen. OCTA had 85.4% and 79.3% specificity and sensitivity, respectively, in determining the presence or absence of CNV. OCTA was 69.5% accurate in determining active CNV. False positives and negatives were 21.6% and 8.0%, respectively.

Conclusions This study suggests that en-face OCTA images allow a moderate ability to identify CNV and that OCTA alone is weak at recognising active CNV requiring treatment in AMD.

  • Retina
  • Imaging
  • Degeneration
  • Macula
  • Neovascularisation

https://doi.org/10.1136/bjophthalmol-2020-316622

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    Footnotes

    • Contributors MCC: Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work; drafting the work or revising it critically for important intellectual content; final approval of the version to be published; and agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. KD, MJ and MA-P: Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work; SB: Drafting the work or revising it critically for important intellectual content; D-UB: Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. EN: Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work; and agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. WF: Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work; and drafting the work or revising it critically for important intellectual content; and final approval of the version to be published; and Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

    • Funding This study was supported in part by UCSD Vision Research Center Core Grant P30EY022589, an unrestricted grant from Research to Prevent Blindness, NY (WRF).

    • Competing interests None declared.

    • Ethics approval This study was approved by the IRB, called Retina Registry (IRB # 12051).

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement Data are available upon reasonable request.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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