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OCT angiography may have place in CNV imaging
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WAILEA, Hawaii – OCT angiography does reasonably well in detecting choroidal neovascularization, except when there are large amounts of subretinal hemorrhage present, according to a presenter at Retina 2015.
Nadia K.
Waheed
Whereas fluorescein angiography is still the gold standard for diagnosing new vessels such as choroidal neovascular lesions and ruling out diseases that mimic age-related macular degeneration, many clinicians do not readily use it, Nadia K. Waheed, MD, MPH,told colleagues at Retina 2015.
“Many of us use [fluorescein angiography] for our patients to make the initial diagnosis of AMD, although increasingly people are moving on to appearance on OCT to make that diagnosis,” she said.
Using the Avanti OCTA platform (Optovue) and using fluorescein angiography as the gold standard for detecting CNV, Waheed and colleagues investigated the specificity and sensitivity of OCTA in detecting CNV.
“What we found was that the sensitivity of the device was about 50%, so it picked up about half of the CNVs, but it missed about half of them. Specificity was very good, about 91%,” she said.
After further investigation of their false-negative reports as verified by fluorescein angiography, Waheed said, “Most of our false-negatives were patients with large amounts of subretinal hemorrhage. You can see the signal on the OCT B-scan being blocked or shadowed, and so you don’t see a CNV, but it’s not because it’s not there, it’s just because there’s no signal there.”
Software enhancements in the future will increase the sensitivity and specificity of OCTA, Waheed said. –by Patricia Nale
Disclosure: Waheed reports no relevant financial disclosures.