Correlation of optical coherence tomography, with or without additional colour fundus photography, with stereo fundus fluorescein angiography in diagnosing choroidal neovascular membranes

Abstract

Aims: To assess the diagnostic accuracy of optical coherence tomography (OCT), with/without colour fundus photographs, in predicting fundus fluorescein angiography (FFA) findings in patients suspected of having choroidal neovascularisation (CNV). Methods: A consecutive series of patients suspected of having CNV underwent OCT and stereo FFA images, which were assigned a diagnosis by two masked observers, one examining OCT alone and then OCT plus stereo colour photographs, and one examining FFA alone. The main outcome measures were the diagnostic accuracy of OCT (with/without colour photos) in predicting the presence of CNV and secondly the characteristics of the CNV compared to the FFA findings. Results: 131 eyes of 118 patients were analysed. The sensitivity and specificity of OCT for detecting new potentially treatable CNV lesions compared to FFA was 96.4%, and 66.0%, respectively. For OCT with stereo images the sensitivity was 94.0% and specificity 89.4%. For detecting CNV with a classic component the sensitivity and specificity of OCT alone was 78.6% and 82.7%. With stereo colour images the sensitivity was 82.1% and specificity 89.3%. Conclusion: OCT is good at detecting the presence of CNV in patients suspected of having new CNV. However, it is less accurate at identifying the exact components of CNV. OCT cannot at present replace FFA in accurately diagnosing CNV components. However, this imaging method may have a role as a screening tool to help prioritise FFA requests.