The diagnostic accuracy of spectral-domain optical coherence tomography for 

neovascular age-related macular degeneration: a comparison with fundus fluorescein angiography

C Wilde, M Patel, A Lakshmanan, R Amankwah, S Dhar Munshi and W Amoaku

Represented by : monika

AMD

Invasive ProcedurePatients have to be cannulated poor venous access

Facilities for resuscitation be availableTime-consuming,

The quality of the images operator dependentInconvenient

Unnecessary before commencing therapy with anti-VEGF therapies

25%>75

Material and Methods

Retrospective SD-OCT,

FP, and FFA 411 patiens

Kings Mill Hospital, Sutton-in-Ashfield

February 2009 to February 2013

 

231(CNV)

47(FALSE)

27 classic no occult 7 disciform scars

16 predominantly classic 40 PED,IRF, SRF, Retinal thickening

50 minimal classic

129 occult

9 peripapillary

Discussion• SD-OCT is increasingly used in clinical practice for the follow-up of patients undergoing treatment with anti-VEGF in nAMD and other retinal vascular disease. 

• It provides a time efficient, noninvasive imaging tool that allows high-resolution, pseudohistological cross-sectional images of the retina, RPE, and choroid. 

• This study confirms that SD-OCT in comparison to the reference standard of non-stereoscopic FFA is highly sensitive (100%) at detecting newly presenting nAMD

• Sandhu et al reported the sensitivity with TD-OCT alone to be 96.4%. 

• The use of TD-OCT has been reported by others to fail frequently in the detection of abnormalities that are associated with fluorescein  leakage from CNV on FFA

• a few studies have demonstrated SD-OCT to be more sensitive at detecting abnormalities associated with nAMD than TD-OCT

• Another recent publication investigating new patients referred for suspected wet AMD also reported a sensitivity of 100%.

• The AMD Doc Study reported a sensitivity of 69% in the detection of conversion to nAMD in high risk eyes. 

• In 5% of eyes in our study no SRF or IRF was present on SDOCT, yet FFA demonstrated an occult lesion. 

• In all of these cases SD-OCT demonstrated a PED. 

• The Topcon 3D OCT 1000 (Topcon) used in this study can image an area of 8.2mm which would have included both the disc and the macular area and may have prevented this grading error.

• The high false-positive rate in the present study represents the difficulty in correctly identifying areas of hyper-reflectivity on SD-OCT that represent active CNV, and distinguishing them from those that represent inactive gliosis, particularly in the setting of chronic lesions.

CONCLUSION

 

TITLE

Too long / short ? No

Illustrate the observed variables ?

Yes

Non standard Abbreviation? None

Any corresponding author and email ?

Author : WM AmoakuE-mail :

winfried.amoaku@nottingham.ac.uk

 ABSTRACT

Consists of 4 parts: background, method, result,

and conclusion ?Yes

Any keywords ? Yes

Is the abstract wholly appropriate?

Yes

AIM & BENEFIT OF THE RESEARCH

Does the aim explained ? Yes

Does the benefit explained ? Yes

 METHODS

Is there any research design ? Yes

Population & samples Yes, it is explained

Inclusion-Exclusion Criteria Yes

Sampling & Sample size formulation

No

Treatment No

 METHODS

Is there any bias on procedure, means, and

subject obedience ?Yes

Is there any operational definition ?

No

Is there any ethical clearance consent ?

Yes

Data analysis ? No

  RESULTS

Any Drop out ? Yes

Is there any subject characteristic table ?

No

Is there any aim for the results?

Yes

What is the main result of the research ?

SD-OCT in comparison to non-stereoscopic FFA is highly sensitive at detecting newly

presenting nAMD but cannot replace FFA in the diagnosis of nAMD in current clinical

practice

DISCUSSIONDid the result suits the

theory ?Yes

Is there any comparison with another research ?

Yes

 CONCLUSION

Could it be applied in chosen sample,

reachable and target population ?

Yes

Could this research be applied for

patients ?Applicable

Mohon Bimbingan dan Saran