Abstract：
OBJECTIVE: 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).
CONCLUSIONS: 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.
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).
CONCLUSIONS: 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.
摘要：
目的：评估谱域光学相干断层扫描（SDOCT）联合OCT血管造影（OCTA）对近视性近视黄斑新生血管形成（MNV）活动的诊断准确性。
方法：近视MNV患者双眼经荧光素血管造影（FA）诊断，SDOCT和OCTA由未掩盖的研究者进行评估。这些图像在被蒙面调查人员分级之前被去识别和随机化，他们通过使用SDOCT和无FA的OCTA以及单独使用FA来确定活动性近视MNV的存在，分别。将蒙面调查人员的发现与未蒙面调查人员进行了比较。
结果：110例患者的213只眼，包括499次影像学发作，符合分级标准。用于诊断没有FA的新发近视MNV，联合使用SDOCT和OCTA的敏感性为0.94,特异性为0.84,曲线下面积(AUC)为0.92.FA的灵敏度为0.52(p<0.01)，特异性为0.80（p=0.38），AUC为0.66（p<0.01）。对于复发性近视MNV，SDOCT和OCTA组合的敏感性为0.98,特异性为0.78,AUC为0.88.FA的灵敏度为0.50(p=0.04)，特异性为0.76（p=0.85），AUC为0.63（p=0.01）。近视牵引性黄斑病变与复发性近视MNV相关频率更高(p<0.01)。
结论：SDOCT与密集体积扫描对诊断近视MNV高度敏感。OCTA的添加提高了无FA的诊断特异性。监测SDOCT的纵向变化和明智地使用FA是近视MNV的可靠监测策略。
方法：近视MNV患者双眼经荧光素血管造影（FA）诊断，SDOCT和OCTA由未掩盖的研究者进行评估。这些图像在被蒙面调查人员分级之前被去识别和随机化，他们通过使用SDOCT和无FA的OCTA以及单独使用FA来确定活动性近视MNV的存在，分别。将蒙面调查人员的发现与未蒙面调查人员进行了比较。
结果：110例患者的213只眼，包括499次影像学发作，符合分级标准。用于诊断没有FA的新发近视MNV，联合使用SDOCT和OCTA的敏感性为0.94,特异性为0.84,曲线下面积(AUC)为0.92.FA的灵敏度为0.52(p<0.01)，特异性为0.80（p=0.38），AUC为0.66（p<0.01）。对于复发性近视MNV，SDOCT和OCTA组合的敏感性为0.98,特异性为0.78,AUC为0.88.FA的灵敏度为0.50(p=0.04)，特异性为0.76（p=0.85），AUC为0.63（p=0.01）。近视牵引性黄斑病变与复发性近视MNV相关频率更高(p<0.01)。
结论：SDOCT与密集体积扫描对诊断近视MNV高度敏感。OCTA的添加提高了无FA的诊断特异性。监测SDOCT的纵向变化和明智地使用FA是近视MNV的可靠监测策略。
