Abstract

Volume.122 Number.10

Original article : Clinical science

Detection of Choroidal Neovascularization in Exudative Age-related Macular Degeneration Using Optical Coherence Tomography Angiography
Ichiro Maruko, Hideki Koizumi, Taizo Kawano, Taiji Hasegawa, Hisaya Arakawa, Tomohiro Iida
Department of Ophthalmology, Tokyo Women's Medical University School of Medicine

Purpose: While optical coherence tomography angiography (OCTA) is useful for detecting choroidal neovascularization (CNV) in patients with age-related macular degeneration (AMD), its detection power is affected by artifacts and segmentation errors. In this study, we investigated whether CNV could be visualized solely by automatic analysis with a built-in OCTA software in consecutive cases of exudative AMD without performing manual analysis or excluding cases with poor quality images.
Subjects and methods: The study included 25 eyes in 24 consecutive cases (19 men and 5 women; mean age, 75.4 years) of untreated exudative AMD. The patients were examined at the Department of Ophthalmology, Tokyo Women's Medical University Hospital. All patients were diagnosed with active AMD based on fundus findings, fluorescein and indocyanine green angiography, and optical coherence tomography. The presence or absence of CNV findings was investigated based on images automatically analyzed with OCTA after diagnosis. Patients with poor quality OCTA images were not excluded from analysis.
Results: The 25 eyes in 24 consecutive cases comprised 11 eyes with typical AMD, 11 eyes with polypoidal choroidal vasculopathy (PCV), and 3 eyes with retinal angiomatous proliferation (RAP). OCTA detected CNV in 88.0% (22 eyes). By disease type, it detected CNV in 90.9% of typical AMD eyes, 81.8% of PCV eyes, and 100% of RAP eyes. Of the 3 eyes in which CNV could not be detected, 100% (3 eyes) had retinal pigment epithelial detachment (PED) and 66.7% (2 eyes) had extensive subfoveal hemorrhage. The presence or absence of CNV was determined successfully for 1 eye with poor quality images in this study.
Conclusions: CNV in AMD was detected at a high rate of 88% with current OCTA automatic analysis. Factors impeding detection were PED and extensive subfoveal hemorrhage.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 122: 744-752, 2018.

Key words
Optical coherence tomography, Choroidal neovascularization, Segmentation, Artifact, Retinal pigment epithelial detachment
Reprint requests to
Ichiro Maruko, M.D. Department of Ophthalmology, Tokyo Women's Medical University School of Medicine. 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan