Abstract
PurposeTo investigate the diagnostic accuracy of noninvasive multimodal imaging methods in diagnosing polypoidal choroidal vasculopathy (PCV) and distinguishing PCV from typical neovascular age-related macular degeneration (nvAMD).MethodsRetrospective study. Imaging features of noninvasive multimodal imaging methods, including fundus photography (FP), B-scan optical coherence tomography (OCT), en face OCT, OCT angiography, and autofluorescence, of 103 eyes with PCV or typical nvAMD were reviewed. Diagnostic strategy was established based on imaging features and was validated in other 105 eyes with PCV or typical nvAMD.ResultsFeatures of subretinal orange nodule on FP, thumb-like PED on OCT, notched PED on OCT, bubble sign on OCT, and Bruch’s membrane depression under serosanguinous PED on OCT were more common. When the diagnostic strategy of using at least 2 of 5 features was performed, there is 0.88 sensitivity and 0.92 specificity for diagnosing PCV. The results of the validation test further confirmed the diagnostic strategy with 0.94 sensitivity and 0.93 specificity.ConclusionsNoninvasive multimodal imaging, especially FP and B-scan OCT, provide high sensitivity and specificity for diagnosing PCV and distinguishing PCV from typical nvAMD, when at least 2 of 5 suggestive imaging features are present.
Highlights
Polypoidal choroidal vasculopathy (PCV) is an important cause of visual loss in elderly, which is characterized with the presence of polypoidal or aneurysmal hyperfluorescent with or with branching vascular network (BVN) on indocyanine green angiography (ICGA) [1]
Ophthalmologists can obtain clues suggesting the diagnosis of PCV using noninvasive imaging methods, including the presence of subretinal orange nodules on fundus photography (FP) and the presence of hyper-reflectivity ring on optical coherence tomography (OCT) B-scans and en face OCT
This study aims to investigate sensitivity, specificity, and predictive accuracy of noninvasive multimodal imaging methods, including FP, B-scan OCT, en face OCT, optical coherence tomography angiography (OCTA), and autofluorescence (AF), to diagnose PCV without using ICGA and to differentiate PCV from typical neovascular agerelated macular degeneration (nvAMD)
Summary
Polypoidal choroidal vasculopathy (PCV) is an important cause of visual loss in elderly, which is characterized with the presence of polypoidal or aneurysmal hyperfluorescent with or with branching vascular network (BVN) on indocyanine green angiography (ICGA) [1]. It is regarded as a subtype of neovascular agerelated macular degeneration (nvAMD), PCV has differences on the natural history, treatment regimens, and prognosis with typical nvAMD [1,2,3,4,5,6]. A provisional diagnosis of PCV might be made based on noninvasive imaging methods without ICGA
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