J Korean Ophthalmol Soc.  2021 Mar;62(3):345-353. 10.3341/jkos.2021.62.3.345.

Diagnostic Availability of Optical Coherence Angiography in Type 1 and 2 Choroidal Neovascularization

• Kim DY
• Kim KS
• Youm JH

• KMID: 2514249
• DOI: http://doi.org/10.3341/jkos.2021.62.3.345

Abstract

Purpose
To report the availability of optical coherence tomography angiography (OCTA) when diagnosing type 1 and type 2 choroidal neovascularization (CNV) associated with age-related macular degeneration.
Methods
We conducted a retrospective chart review of 63 eyes of 59 patients who visited the outpatient clinic from April 2018 to January 2020 with treatment-naïve type 1/2 CNV associated with age-related macular degeneration. The CNV was diagnosed through fluorescein angiography and indocyanine green angiography on the appearance of hyperfluorescence and leakage at the late phase. The CNV type was classified by location using OCT. These results were compared with those of automatic and manual segmentations via OCTA.
Results
Of the 63 eyes, 45 eyes showed type 1 CNV and 18 eyes indicated type 2 CNV. Using the automatic segmented display of OCTA, type 1 CNV was identified in 29 of 45 eyes and type 2 CNV was confirmed in 17 of 18 eyes. In addition, when manual segmentation was performed, type 1 CNV was found in 41 of 45 eyes and type 2 CNV in 18 of 18 eyes. The sensitivity of diagnosis of type 1 CNV using only automatic segmentation in OCTA was 64.44%; the sensitivity increased to 91.11% when additional manual segmentation was performed (p < 0.001). For type 2 CNV, the sensitivity was 94.44% using automatic segmentation in OCTA and 100% with additional manual segmentation (p = 1.000).
Conclusions
Automatic segmentation of OCTA and OCT analyses enabled diagnosis of type 1 and type 2 CNV associated with age-related macular degeneration. The diagnosis accuracy or type 1 CNV improved significantly when manual segmentation was added.

Keyword

Choroidal neovascularization, Manual segmentation, Optical coherence tomography angiography