OCT angiography (OCT-A) imaging appears to be on par with indocyanine green angiography (ICGA) in the diagnosis of treatment-naïve polypoidal choroidal vasculopathy (PCV), but when comparing the two, researchers recently found OCT-A may have a leg up on being able to find more polypoidal lesions and branching vascular networks.
The study, published in the American Journal of Ophthalmology, included 30 patients with treatment-naïve PCV found on ICGA who also underwent same day OCT-A imaging at Kyung Hee University Medical Center in South Korea between 2017 and 2018. The investigators graded the ICGA and OCT-A images independently with the latter using both flow and structural information. In both sets of images, the researchers considered the number of polypoidal lesions and the total lesion area, which included both the polypoidal lesions and branching vascular networks.
Polypoidal lesions were identified in all eyes using each imaging modality.
The two imaging tools agreed on the number of polypoidal lesions in 17 eyes (55%). In 12 eyes (39%), OCT-A graders identified more polypoidal lesions, while ICGA graders found more lesions in only two eyes (6%).
The investigators didn’t find any significant differences in the lesion area measurements. They noted the lesion with the largest difference in area measurements was the result of focal areas of atrophy—which were misdiagnosed as polypoidal lesions on ICGA—and a low-lying serous retinal pigment epithelial detachment, which was incorrectly identified by ICGA graders as being part of the branching vascular networks.
OCT-A imaging correctly diagnosed the focal areas of atrophy and the serous pigment epithelial detachment, the researchers noted.
|Kim K, Yang J, Feuer W, et al. A comparison study of polypoidal choroidal vasculopathy imaged with indocyanine green angiography and swept source OCT angiography. Am J Ophthalmol. May 21, 2020. [Epub ahead of print].|