TY - JOUR
T1 - Color Fundus Photography, Optical Coherence Tomography, and Fluorescein Angiography in Diagnosing Polypoidal Choroidal Vasculopathy
AU - Chaikitmongkol, Voraporn
AU - Khunsongkiet, Preeyanuch
AU - Patikulsila, Direk
AU - Ratanasukon, Mansing
AU - Watanachai, Nawat
AU - Jumroendararasame, Chaisiri
AU - Mayerle, Catherine B.
AU - Han, Ian C.
AU - Chen, Connie J.
AU - Winaikosol, Pawara
AU - Dejkriengkraikul, Chutikarn
AU - Choovuthayakorn, Janejit
AU - Kunavisarut, Paradee
AU - Bressler, Neil M.
N1 - Funding Information:
Funding/Support: Funding of this study was provided by Research Committee, Faculty of Medicine, Chiang Mai University, and unrestricted donations to Johns Hopkins University for retina research. Financial Disclosures: Voraporn Chaikitmongkol reported receiving research grants from Bayer and ThromboGenics; and travel expenses from Allergan, Bayer, and Novartis. Direk Patikulsila reported working as a consultant, receiving honoraria and travel expenses from Bayer and Novartis; and honoraria and travel expenses from Alcon. Mansing Ratanasukon reported receiving honoraria and travel expenses from Bayer and Novartis. Nawat Watanachai reported receiving honoraria and travel expenses from Alcon, Allergan, Bayer, and Novartis. Chaisiri Jumroendararasame reported receiving travel expenses from Allergan, Bayer, and Novartis. Janejit Choovuthayakorn reported receiving honoraria and travel expenses from Alcon, Allergan, Bayer, and Novartis. Paradee Kunavisarut reported receiving honoraria and travel expenses from Novartis. Neil M. Bressler reported receiving grants to his employer, the Johns Hopkins University School of Medicine, from Bayer, Novartis, Roche (Genentech), and Samsung Bioepis. The following authors have no financial disclosures: Preeyanuch Khunsongkiet, Catherine B. Mayerle, Ian C. Han, Connie J. Chen, Pawara Winaikosol, and Chutikarn Dejkriengkraikul. All authors attest that they meet the current ICMJE criteria for authorship.
Publisher Copyright:
© 2018 Elsevier Inc.
Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 2018/8
Y1 - 2018/8
N2 - Purpose: To determine sensitivity and specificity of polypoidal choroidal vasculopathy (PCV) diagnosis using color fundus photography (CFP), optical coherence tomography (OCT), and fundus fluorescein angiography (FFA) without indocyanine green angiography (ICGA). Design: Validity analysis. Methods: Treatment-naïve eyes with serous/serosanguinous maculopathy undergoing CFP, OCT, FFA, and ICGA imaging before treatment at a university hospital in Thailand (January 1, 2013 to June 30, 2015) were identified. Images of each subject were categorized into 4 sets (set A: CFP; set B: CFP+OCT; set C: CFP+FFA; set D: CFP+OCT+FFA). Six graders, 3 from Thailand (PCV endemic area) and 3 from the United States (nonendemic area), individually reviewed each set (without ICGA), and determined if the presumed diagnosis was PCV. In parallel, 2 other graders confirmed if each case had PCV or not using EVEREST criteria (including ICGA). Sensitivity and specificity of a PCV diagnosis with each set (without ICGA) were analyzed compared with diagnoses including ICGA. Results: Of 119 study eyes (113 subjects, 57% male, mean age ± SD 59.9 ± 13.8 years), definite PCV diagnosis was 40.3%. Sensitivity of sets A, B, C, D: 0.63 (95% confidence interval [CI]: 0.47–0.76), 0.83 (95% CI: 0.69–0.92), 0.54 (95% CI: 0.39–0.68), 0.67 (95% CI: 0.51–0.79); specificities: 0.93 (95% CI: 0.84–0.97), 0.83 (95% CI: 0.72–0.91), 0.97 (95% CI: 0.89–0.99), 0.92 (95% CI: 0.82–0.97); accuracies: 0.81 (95% CI: 0.73–0.88), 0.83 (95% CI: 0.76–0.90), 0.79 (95% CI: 0.73–0.87), 0.82 (95% CI: 0.74–0.88). Discrepancies between Thai and US graders existed through sets A, C, and D. Conclusions: These data suggest that without ICGA, fundus photography combined with OCT provides high sensitivity and high specificity to diagnose PCV; adding FFA does not improve accuracy.
AB - Purpose: To determine sensitivity and specificity of polypoidal choroidal vasculopathy (PCV) diagnosis using color fundus photography (CFP), optical coherence tomography (OCT), and fundus fluorescein angiography (FFA) without indocyanine green angiography (ICGA). Design: Validity analysis. Methods: Treatment-naïve eyes with serous/serosanguinous maculopathy undergoing CFP, OCT, FFA, and ICGA imaging before treatment at a university hospital in Thailand (January 1, 2013 to June 30, 2015) were identified. Images of each subject were categorized into 4 sets (set A: CFP; set B: CFP+OCT; set C: CFP+FFA; set D: CFP+OCT+FFA). Six graders, 3 from Thailand (PCV endemic area) and 3 from the United States (nonendemic area), individually reviewed each set (without ICGA), and determined if the presumed diagnosis was PCV. In parallel, 2 other graders confirmed if each case had PCV or not using EVEREST criteria (including ICGA). Sensitivity and specificity of a PCV diagnosis with each set (without ICGA) were analyzed compared with diagnoses including ICGA. Results: Of 119 study eyes (113 subjects, 57% male, mean age ± SD 59.9 ± 13.8 years), definite PCV diagnosis was 40.3%. Sensitivity of sets A, B, C, D: 0.63 (95% confidence interval [CI]: 0.47–0.76), 0.83 (95% CI: 0.69–0.92), 0.54 (95% CI: 0.39–0.68), 0.67 (95% CI: 0.51–0.79); specificities: 0.93 (95% CI: 0.84–0.97), 0.83 (95% CI: 0.72–0.91), 0.97 (95% CI: 0.89–0.99), 0.92 (95% CI: 0.82–0.97); accuracies: 0.81 (95% CI: 0.73–0.88), 0.83 (95% CI: 0.76–0.90), 0.79 (95% CI: 0.73–0.87), 0.82 (95% CI: 0.74–0.88). Discrepancies between Thai and US graders existed through sets A, C, and D. Conclusions: These data suggest that without ICGA, fundus photography combined with OCT provides high sensitivity and high specificity to diagnose PCV; adding FFA does not improve accuracy.
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U2 - 10.1016/j.ajo.2018.05.005
DO - 10.1016/j.ajo.2018.05.005
M3 - Article
C2 - 29753852
AN - SCOPUS:85047618615
SN - 0002-9394
VL - 192
SP - 77
EP - 83
JO - American journal of ophthalmology
JF - American journal of ophthalmology
ER -