ABSTRACT
PURPOSE: To determine the sensitivity of the combination of optical coherence tomography angiography (OCTA) and structural optical coherence tomography (OCT) for detecting type 1 neovascularization (NV) and to determine significant factors that preclude visualization of type 1 NV using OCTA. METHODS: Multicenter, retrospective cohort study of 115 eyes from 100 patients with type 1 NV. A retrospective review of fluorescein (FA), OCT, and OCTA imaging was performed on a consecutive series of eyes with type 1 NV from five institutions. Unmasked graders utilized FA and structural OCT data to determine the diagnosis of type 1 NV. Masked graders evaluated FA data alone, en face OCTA data alone and combined en face OCTA and structural OCT data to determine the presence of type 1 NV. Sensitivity analyses were performed using combined FA and OCT data as the reference standard. RESULTS: A total of 105 eyes were diagnosed with type 1 NV using the reference. Of these, 90 (85.7%) could be detected using en face OCTA and structural OCT. The sensitivities of FA data alone and en face OCTA data alone for visualizing type 1 NV were the same (66.7%). Significant factors that precluded visualization of NV using en face OCTA included the height of pigment epithelial detachment, low signal strength, and treatment-naïve disease (P < 0.05, respectively). CONCLUSIONS: En face OCTA and structural OCT showed better detection of type 1 NV than either FA alone or en face OCTA alone. Combining en face OCTA and structural OCT information may therefore be a useful way to noninvasively diagnose and monitor the treatment of type 1 NV.
Subject(s)
Choroid/pathology , Choroidal Neovascularization/diagnosis , Fluorescein Angiography/methods , Retinal Vessels/pathology , Tomography, Optical Coherence/methods , Adult , Aged , Aged, 80 and over , Female , Follow-Up Studies , Fundus Oculi , Humans , Male , Middle Aged , Reproducibility of Results , Retrospective Studies , Severity of Illness Index , Time Factors , Visual AcuityABSTRACT
PURPOSE: To describe novel cystic structures ('outer retinal cysts' or ORC) found in the outer retina in age-related macular degeneration (AMD). METHODS: One hundred and seventy-three consecutive eyes of 88 AMD patients were prospectively examined with spectral domain optical coherence tomography (SD-OCT). The prevalence of ORCs was searched, and their sizes and shapes were determined. RESULTS: SD-OCT revealed round or ovoid, intraretinal, hyporeflective cystic structures with a hyperreflective border in 60 eyes (56%) with neovascular AMD and in six eyes (21%) with atrophic AMD. These cystic structures were of different sizes and shapes. They remained stable in all the patients after a follow-up period of 6 months. CONCLUSIONS: Outer retinal cyst is a new type of cystic structure recently identified in AMD patients. ORCs should not be confused with intraretinal exudates or cystoid cavities and therefore do not require any treatment. The histopathological nature of ORC remains to be determined. Further studies are necessary to determine their true origin.
