目的:评估扫频源光学相干断层扫描血管造影(SS-OCTA)鉴别黄斑病变的可行性,包括非息肉状黄斑新生血管(MNV),息肉状脉络膜血管病变(PCV),3型MNV,和慢性中心性浆液性脉络膜视网膜病变(CSC),无吲哚菁绿血管造影(ICGA)。
方法:回顾性观察研究。
方法:本研究检查了63例新生血管性年龄相关性黄斑变性(AMD)患者的63只眼,包括23只非息肉状MNV的眼睛,17只眼睛与PCV,3型MNV1只眼和慢性CSC22只眼。两位独立的视网膜专家,对临床诊断视而不见,仅使用B扫描和SS-OCTA的面部图像评估每例新生血管性AMD和慢性CSC,而不参考其他检查结果。
结果:仅通过SS-OCTA,19只眼被诊断为非息肉状MNV,17只眼睛与PCV,2眼3型MNV,和22只患有慢性CSC的眼睛,指示高灵敏度(82.6%,94.1%,100%,100%,分别)和特异性(100%,97.8%,98.4%,100%,分别);然而,由于图像模糊,三只眼睛无法诊断。两位专家之间单独使用SS-OCTA诊断的一致性很高(κ=0.82)。
结论:SS-OCTA在非息肉样MNV的分化中显示出较高的敏感性和特异性,PCV,3型MNV,慢性CSC。基于SS-OCTA的差异标准可以替代基于ICGA的诊断。
OBJECTIVE: To assess the feasibility of swept-source optical coherence tomography angiography (SS-OCTA) to differentiate macular diseases, including nonpolypoidal macular neovascularization (MNV), polypoidal choroidal vasculopathy (PCV), type 3 MNV, and chronic central serous chorioretinopathy (CSC) without indocyanine green angiography (ICGA).
METHODS: Retrospective observational study.
METHODS: This study examined 63 eyes of 63 patients with treatment-naive neovascular age-related macular degeneration (AMD), including 23 eyes with nonpolypoidal MNV, 17 eyes with PCV, and 1 eye with type 3 MNV and 22 eyes with chronic CSC. Two independent retina specialists, blinded to the clinical diagnosis, assessed each case of neovascular AMD and chronic CSC using only B-scan and en face images of SS-OCTA without referring to other examination outcomes.
RESULTS: By SS-OCTA alone, 19 eyes were diagnosed with nonpolypoidal MNV, 17 eyes with PCV, 2 eyes with type 3 MNV, and 22 eyes with chronic CSC, indicating high sensitivity (82.6%, 94.1%, 100%, and 100%, respectively) and specificity (100%, 97.8%, 98.4%, and 100%, respectively); however, three eyes could not be diagnosed because of obscure images. The agreement of diagnosis with SS-OCTA alone was high between the two specialists (κ = 0.82).
CONCLUSIONS: SS-OCTA showed high sensitivity and specificity in the differentiation of nonpolypoidal MNV, PCV, type 3 MNV, and chronic CSC. The differential criteria based on SS-OCTA could be a substitute for the ICGA-based diagnoses.