PURPOSE. To investigate the potential of optical coherence tomography (OCT) angiography to detect and quantify the neovascular network in exudative AMD. METHODS. Treatment-näıve eyes that were diagnosed with exudative AMD were prospectively examined by OCT angiography (OCT-A). The extent of the neovascular network was measured by three independent readers. Interclass-correlation coefficient and area overlap coefficients (OC) were calculated to assess locally precise agreement between measurements. As a reference for interreader agreement, the extent of the neovascular network was further measured on fluorescein angiography (FA) images. RESULTS. A total of 31 eyes (27 patients, mean age 82.5 years, 15 female) were included in the study. Neovascularization subtype was classified as type I in 5, type II in 11, type III in 9, and mixed in 6 eyes, respectively. Interreader agreement for measurements of the neovascular network was 0.884 for OCT-A and 0.636 for FA. Overlap coefficient was 0.705 (interquartile [IQR]: 0.450-0.76) for OCT-A and 0.704 (IQR: 0.673-0.750) for FA, respectively. Area agreement was weaker in type III and mixed lesions. CONCLUSIONS. Optical coherence tomography angiography-based measurements of the new vessel complex in neovascular AMD are feasible with interreader agreement comparable with the values obtained for FA. The results underscore the potential of OCT-A as a noninvasive diagnostic tool in neovascular AMD. Yet, further studies will be required to reveal the origin of poor agreement observed in single eyes and to advance OCT-A toward dependable use (e.g., in a reading center context).
Lindner, M., Fang, P. P., Steinberg, J. S., Domdei, N., Pfau, M., Krohne, T. U., … Fleckenstein, M. (2016). OCT angiography-based detection and quantification of the neovascular network in exudative AMD. Investigative Ophthalmology and Visual Science, 57(14), 6342–6348. https://doi.org/10.1167/iovs.16-19741