在息肉状脉络膜血管病变(PCV)的背景下制定共识术语,并制定和验证一套不需要吲哚菁绿血管造影(ICGA)的诊断标准,以根据OCT和彩色眼底摄影结果将PCV与典型的新生血管性年龄相关性黄斑变性(nAMD)区分开来。
诊断测试结果的评估。
视网膜专家小组。
作为亚太眼部影像学会的一部分,一个国际专家组调查并讨论了有关PCV当前命名法和病变成分的已发表文献,并提出了更新的共识命名法,反映了我们基于影像学和组织学报告的最新理解.工作组根据OCT图像和彩色眼底照片评估了PCV的一组诊断特征,可以将其与典型的nAMD区分开来,并评估了这些非ICGA特征的个体和组合的性能。旨在提出一套不需要使用ICGA的新诊断标准。最终建议在来自2个额外队列的80只眼睛中进行了验证。
PCV病变成分的一致命名系统和基于非ICGA的标准,以区分PCV和典型nAMD。
工作组推荐术语息肉样病变和分支新生血管网络作为PCV的2个关键病变成分。对于PCV的诊断,结合3个基于OCT的主要标准(视网膜下色素上皮[RPE]环状病变,面对OCT复杂的RPE立面图,和尖峰PED)在接收器工作特性曲线下的面积为0.90。在一个单独的子集80只眼睛中验证了这一新方案,精度达到了82%。
我们提出了PCV病变成分的最新术语,以更好地反映这些病变的性质,并基于国际共识。在不常规进行ICGA的临床环境中,一组易于应用于谱域OCT结果的实用诊断标准可用于高精度诊断PCV。
To develop
consensus terminology in the setting of polypoidal choroidal vasculopathy (PCV) and to develop and validate a set of diagnostic criteria not requiring indocyanine green angiography (ICGA) for differentiating PCV from typical neovascular age-related macular degeneration (nAMD) based on a combination of OCT and color fundus photography findings.
Evaluation of diagnostic test results.
Panel of retina specialists.
As part of the Asia-Pacific Ocular Imaging Society, an international group of experts surveyed and discussed the published literature regarding the current nomenclature and lesion components for PCV, and proposed an updated
consensus nomenclature that reflects our latest understanding based on imaging and histologic reports. The workgroup evaluated a set of diagnostic features based on OCT images and color fundus photographs for PCV that may distinguish it from typical nAMD and assessed the performance of individual and combinations of these non-ICGA features, aiming to propose a new set of diagnostic criteria that does not require the use of ICGA. The final recommendation was validated in 80 eyes from 2 additional cohorts.
Consensus nomenclature system for PCV lesion components and non-ICGA-based criteria to differentiate PCV from typical nAMD.
The workgroup recommended the terms polypoidal lesion and branching neovascular network for the 2 key lesion components in PCV. For the diagnosis of PCV, the combination of 3 OCT-based major criteria (sub-retinal pigment epithelium [RPE] ring-like lesion, en face OCT complex RPE elevation, and sharp-peaked PED) achieved an area under the receiver operating characteristic curve of 0.90. Validation of this new scheme in a separate subset 80 eyes achieved an accuracy of 82%.
We propose updated terminology for PCV lesion components that better reflects the nature of these lesions and is based on international
consensus. A set of practical diagnostic criteria applied easily to spectral-domain OCT results can be used for diagnosing PCV with high accuracy in clinical settings in which ICGA is not performed routinely.