Grading of Age-Related Macular Degeneration: Comparison between Color Fundus Photography, Fluorescein Angiography, and Spectral Domain Optical Coherence Tomography

Purpose. To compare color fundus photography (FP), fluorescein angiography (FA), and spectral domain optical coherence tomography (SDOCT) for the detection of age-related macular degeneration (AMD), choroidal neovascularisation (CNV), and CNV activity. Methods. FPs, FAs, and SDOCT volume scans from 120 eyes of 66 AMD and control patients were randomly collected. Control eyes were required to show no AMD, but other retinal pathology was allowed. The presence of drusen, pigmentary changes, CNV, and signs for CNV activity was independently analyzed for all imaging modalities. Results. AMD was diagnosed based on FP in 75 eyes. SDOCT and FA showed sensitivity (specificity) of 89% (76%) and 92% (82%), respectively. CNV was present on FA in 68 eyes. Sensitivity (specificity) was 78% (100%) for FP and 94% (98%) for SDOCT. CNV activity was detected by SDOCT or FA in 60 eyes with an agreement in 46 eyes. Sensitivity was 88% for SDOCT and 88% for FA. FP showed sensitivity of 38% and specificity of 98%. Conclusions. CNV lesions and activity may be missed by FP alone, but FP may help identifying drusen and pigmentary changes. SDOCT is highly sensitive for the detection of AMD, CNV, and CNV activity; however, it cannot fully replace FA.

[1]  Laser photocoagulation of subfoveal neovascular lesions of age-related macular degeneration. Updated findings from two clinical trials. Macular Photocoagulation Study Group. , 1993, Archives of ophthalmology.

[2]  P T de Jong,et al.  An international classification and grading system for age-related maculopathy and age-related macular degeneration , 1995 .

[3]  H. Grossniklaus,et al.  Clinicopathologic correlations of surgically excised type 1 and type 2 submacular choroidal neovascular membranes. , 1998, American journal of ophthalmology.

[4]  The Age-Related Eye Disease Study system for classifying age-related macular degeneration from stereoscopic color fundus photographs: the Age-Related Eye Disease Study Report Number 6. , 2001, American journal of ophthalmology.

[5]  J. Català Mora,et al.  Photodynamic Therapy Of Subfoveal Choroidal Neovascularization With Verteporfin. Fluorescein angiographic guidelines for evaluation and treatment-TAP and VIP report nº2 , 2003 .

[6]  N. Bressler.  Age-related macular degeneration is the leading cause of blindness... , 2004, JAMA.

[7]  Richard F Spaide,et al.  COMPARISON OF FLUORESCEIN ANGIOGRAPHY AND OPTICAL COHERENCE TOMOGRAPHY FOR PATIENTS WITH CHOROIDAL NEOVASCULARIZATION AFTER PHOTODYNAMIC THERAPY , 2005, Retina.

[8]  Susan Schneider,et al.  Ranibizumab versus verteporfin for neovascular age-related macular degeneration. , 2006, The New England journal of medicine.

[9]  Johanna M Seddon,et al.  Evaluation of the clinical age-related maculopathy staging system. , 2006, Ophthalmology.

[10]  K. Eng,et al.  Ranibizumab in neovascular age-related macular degeneration , 2006, Clinical interventions in aging.

[11]  Peter K Kaiser,et al.  Angiographic and optical coherence tomographic results of the MARINA study of ranibizumab in neovascular age-related macular degeneration. , 2007, Ophthalmology.

[12]  William J Feuer,et al.  An optical coherence tomography-guided, variable dosing regimen with intravitreal ranibizumab (Lucentis) for neovascular age-related macular degeneration. , 2007, American journal of ophthalmology.

[13]  T. Clark,et al.  DISCREPANCY BETWEEN FLUORESCEIN ANGIOGRAPHY AND OPTICAL COHERENCE TOMOGRAPHY IN DETECTION OF MACULAR DISEASE , 2008, Retina.

[14]  Srinivas R Sadda,et al.  Comparison of clinically relevant findings from high-speed fourier-domain and conventional time-domain optical coherence tomography. , 2009, American journal of ophthalmology.

[15]  K Bailey Freund,et al.  Outer retinal tubulation: a novel optical coherence tomography finding. , 2009, Archives of ophthalmology.

[16]  Sina Farsiu,et al.  Quantitative comparison of drusen segmented on SD-OCT versus drusen delineated on color fundus photographs. , 2010, Investigative ophthalmology & visual science.

[17]  N. Bressler,et al.  Agreement of time-domain and spectral-domain optical coherence tomography with fluorescein leakage from choroidal neovascularization. , 2010, Ophthalmology.

[18]  Cathy Frey,et al.  Investigative Ophthalmology and Visual Science , 2010 .

[19]  Glenn J Jaffe,et al.  Ranibizumab and bevacizumab for neovascular age-related macular degeneration. , 2011, The New England journal of medicine.

[20]  Joan W. Miller,et al.  Spectral-domain optical coherence tomography as an indicator of fluorescein angiography leakage from choroidal neovascularization. , 2011, Investigative ophthalmology & visual science.

[21]  Sharon D. Solomon,et al.  Detection of new-onset choroidal neovascularization using optical coherence tomography: the AMD DOC Study. , 2012, Ophthalmology.

[22]  Adnan Tufail,et al.  Evaluation of age-related macular degeneration with optical coherence tomography. , 2012, Survey of ophthalmology.