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  • Improved accuracy of spectral-domain optical coherence tomography and optical coherence tomography angiography for monitoring myopic macular neovascularisation activity

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Improved accuracy of spectral-domain optical coherence tomography and optical coherence tomography angiography for monitoring myopic macular neovascularisation activity
  1. Danny Siu-Chun Ng1,2,
  2. Li Jia Chen1,3,
  3. Leo Ka Yu Chan1,4,
  4. Fang Yao Tang1,
  5. Wee-Min Teh5,
  6. Linbin Zhou1,
  7. Fiona Chan1,
  8. Eleanor Sui Sum Lin1,
  9. Ka Wai Yuen1,
  10. Wai Kit Chu1,
  11. Shaheeda Mohamed1,4,
  12. Chi Wai Tsang1,4,
  13. Xinyuan Zhang6,
  14. Jason C Yam1,4,
  15. Chi-Pui Pang1,
  16. Timothy Y Y Lai1,7
  1. 1 Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong
  2. 2 Hong Kong Baptist Hospital, Hong Kong, Hong Kong
  3. 3 Department of Ophthalmology and Visual Science, Prince of Wales Hospital, Hong Kong, Hong Kong
  4. 4 Hong Kong Eye Hospital, Hong Kong, Hong Kong
  5. 5 OasisEye Specialists, Seremban, Malaysia
  6. 6 Beijing Tongren Eye Center, Beijing, China
  7. 7 2010 Retina & Macula Centre, Hong Kong, Hong Kong
  1. Correspondence to Dr Danny Siu-Chun Ng; dannyng{at}cuhk.edu.hk

Abstract

Background/aims To evaluate the diagnostic accuracy of spectral-domain optical coherence tomography (SD OCT) combined with OCT angiography (OCTA) for myopic myopic macular neovascularisation (MNV) activity.

Methods Both eyes of patients with myopic MNV diagnosed with fluorescein angiography (FA), SD OCT and OCTA were assessed by unmasked investigators. The images were deidentified and randomised before graded by masked investigators, who determined the presence of active myopic MNV by using SD OCT together with OCTA without FA and by FA alone, respectively. The findings of masked investigators were compared with unmasked investigators.

Results 213 eyes of 110 patients comprising 499 imaging episodes were eligible for grading. For diagnosing new-onset myopic MNV without FA, combined use of SD OCT and OCTA had a sensitivity of 0.94, specificity of 0.84 and area under the curve (AUC) of 0.92. FA had a sensitivity of 0.52 (p<0.01), specificity of 0.80 (p=0.38) and AUC of 0.66 (p<0.01). For recurrent myopic MNV, the combination of SD OCT and OCTA had a sensitivity of 0.98, specificity of 0.78 and AUC of 0.88. FA had a sensitivity of 0.50 (p=0.04), specificity of 0.76 (p=0.85) and AUC of 0.63 (p=0.01). Myopic traction maculopathy was more frequently associated with recurrent myopic MNV (p<0.01).

Conclusion SD OCT with dense volumetric scan was highly sensitive for diagnosing myopic MNV. The addition of OCTA improved the diagnostic specificity without FA. Monitoring of the longitudinal changes on SD OCT and judicious use of FA is a reliable surveillance strategy for myopic MNV.

  • Macula
  • Neovascularisation
  • Imaging
  • Diagnostic tests/Investigation
  • Retina

Data availability statement

Data are available on reasonable request. The data that support the findings of this study are available from the corresponding author, DS-CN, on reasonable request.

https://doi.org/10.1136/bjo-2023-323374

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    Data availability statement

    Data are available on reasonable request. The data that support the findings of this study are available from the corresponding author, DS-CN, on reasonable request.

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    Footnotes

    • X @JasonYam7

    • Contributors DS-CN designed the data collection tools, monitored data collection, wrote the statistical analysis plan, drafted and revised the paper. He is the guarantor. LJC, LKYC, FYT, W-MT, LZ, FC and SM were involved in data collection. ESSL, KWY and WKC were involved in monitoring of data collection, data cleaning and statistical analysis. CWT, XZ and TYYL were involved in statistical analysis, drafting and revising the paper. JCY and C-PP were involved in data interpretation, drafting and revising the paper. Ng DS-C is guarantor.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

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