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  • Sensitivity and Specificity of OCT-A to Detect Choroidal Neovascularization

    By Jean Shaw and selected by Andrew P. Schachat, MD
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    Journal Highlights

    Ophthalmology Retina, July/August 2017

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    Faridi et al. set out to determine the sensitivity and specificity of optical coherence tomography angiography (OCT-A) when used to detect choroi­dal neovascularization (CNV) in eyes with age-related macular degeneration (AMD). They found that a combined approach—en face OCT-A plus cross-sectional OCT-A—is not only superior to that of en face OCT-A alone but also approaches the accuracy of the gold standard, fluorescein angiography.

    The researchers evaluated 72 eyes. Of these, 32 had treatment-naïve CNV, 20 had dry AMD, and the remaining 20 had no pathology. All eyes were assessed via spectral-domain OCT (SD-OCT), and the 3D angiogram was segmented into separate en face views, including the inner retinal angiogram, the outer retinal angiogram, and the choriocapillaris angiogram. Two masked graders then reviewed the fol­lowing sets of images: en face OCT-A alone, SD-OCT alone, and en face OCT-A plus cross-sectional OCT-A.

    In evaluating the 32 eyes with CNV, both graders identified 26 true positives with en face OCT-A alone, for a sensi­tivity of 81.3%. SD-OCT alone had a sensitivity of 100%, as did the combi­nation of en face OCT-A and cross-sectional OCT-A. The specificity results were 92.5% for grader A and 97.5% for grader B for en face OCT-A alone; 97.5% for grader A and 97.5% for grader B for SD-OCT alone; and 97.5% for grader A and 100% for grader B for the combination of en face OCT-A and cross-sectional OCT-A.

    The researchers noted that larger clinical studies are needed to validate the use of OCT-A in determining whether any visualized fluid is related to CNV or to other retinal diseases, such as diabetic macular edema or retinal vein occlusion. In the interim, they said, the process of reviewing cross-sectional OCT-A scans should help clinicians both confirm the pres­ence of CNV and distinguish between pathology and artifact.

    The original article can be found here.