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

医学 光学相干层析成像 眼科 荧光血管造影 血管造影 核医学 放射科 视力
作者
Danny Siu‐Chun Ng,Li Jia Chen,Leo Ka Yu Chan,Fang Tang,Wee-Min Teh,Linbin Zhou,Fiona Chan,Eleanor Sui Sum Lin,Ka Wai Yuen,Wai Kit Chu,Shaheeda Mohamed,Chi Wai Tsang,Xinyuan Zhang,Jason C. Yam,Chi‐Pui Pang,Timothy Y. Y. Lai
出处
期刊:British Journal of Ophthalmology [BMJ]
卷期号:108 (12): 1729-1736
标识
DOI:10.1136/bjo-2023-323374
摘要

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.
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