Noninvasive multimodal imaging in diagnosing polypoidal choroidal vasculopathy

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.

Visual outcomes, safety profile and morphometric response of optical coherence tomography biomarkers to ranibizumab biosimilar treatment in neovascular age-related macular degeneration: Real-world evidence

“…Multiple publications have demonstrated OCT-based criteria for diagnosing PCV and differentiating it from AMD. [ 27 28 29 30 31 ] Very recently, a Consensus committee from the “Asia-Pacific Ocular Imaging Society PCV Workgroup” have published set of practical diagnostic criteria for PCV based on SD-OCT with high accuracy in clinical settings in which ICGA is not performed routinely. [ 32 ] Although we did not perform ICG for our patients, the eyes with PCV/PNV were excluded from our study, based on other multimodal imaging features.…”

Evaluation of clinical findings, optical coherence tomography, fundus flourescein angiography and indocyanine green angiography imaging in patients with Polypoidal Choroidal Vasculopathy

“…ICGA is considered the gold standard imaging method for diagnosing PCV, but it is an invasive technique, it includes a risk of developing allergies to indocyanine green dye, and it is still not accessible in some areas. Therefore, noninvasive diagnostic criteria were needed (3). Previous studies have described some SD-OCT findings that may be specific for the diagnosis of PCV.…”

“…Polypoidal choroidal vasculopathy (PCV) is an idiopathic disorder characterized by the presence of polypoidal or aneurysmal hyperfluorescence with or without a branching vascular network (BVN) visible with indocyanine green angiography (ICGA), and leads to the development of recur-rent serosanguinous retinal pigment epithelial detachments (PED) (1)(2)(3). PCV is considered a peculiar phenotype of neovascular age-related macular degeneration (nAMD) by some (4), or a distinct clinical entity by others (5,6).…”

Deep learning and ensemble stacking technique for differentiating polypoidal choroidal vasculopathy from neovascular age-related macular degeneration

“…Even though single-modal imaging analysis using ICGA to differentiate PCV from AMD have reported well results 16 , it is still limited by the exam process and the accessibility to ICGA. Other studies that attempted to distinguish PCV using multi-modal image have yielded good results 9 , 17 . However, multi-modal imaging analysis remains challenging, it still worth the effort to develop a novel DL model for clinical practice.…”