Florence Coscas


Activity Criteria of CNV in AMD: OCT-A Evaluation During Follow-up SS-OCTA versus OCT-B

 

Florence Coscas, Jean François Boulet, Rita Serra, Alexandre Sellam, Marco Lupidi, Diogo Cabral, Gabriel Coscas, Eric H Souied

 

Abstract:

 

Purpose:

To describe and analyze OCTA findings, based on activity criteria, in treated exudative AMD Swept Source OCTA versus structural OCT-B.  Material and methods:

 

Method:

Retrospective study of 126 files of exudative AMD, Anti VEGF treated with last injection less 3 months ago. FA+- ICG +OCT-B for initial diagnosis (type 3 and PVC excluded). Follow up is based on Structural OCT. OCT Angiography (Triton) was performed at visit of retreatment decision.

 We compare sensibility, specificity, predictive values, relative risk of OCTA qualitative criteria Tiny branching peripheral anastomotic arcade, loops, halo and fluids on structural OCT for therapeutic decision based on exudative neovascular activity of choroidal neovascularization.

 

Results:

The sensitivity is excellent 96,7%, the specificity is good 66,7%, The predictive values depend of the prevalence of the disease. (71.40%) with VPP (87.90%) and VVP (88.90%), the False positive rate (9,2%) and false negative rate (2,98%) for tiny branching and peripheral arcade. The intra grader coefficient kappa is 0.84 The inter grader coefficient is 0.78.  A third grader from another team had a concordance de 82%. The clear presence of these 2 predicting factors increases the probability of treatment to 95.68 %. For Patients with peripheral anastomotic arcade, increased by 2.41. For Patients with tiny branching, increased by 6,76. the curve ROC indicates that this model, correctly predicted the injection in 94.7% cases.

 

Conclusion:

This study could allow the possibility to create a model allowing definition of IVT relative risk (therapeutic decision) according results of Swept Source OCTA imaging. The Main Criteria, Peripheral arcade and tiny branching Are associated with a high probability of treatment. During follow up, the variable status of lesions (persistent, quiescent, recurrent) Require more than one qualificative criteria for stronger valid conclusion, still to be validated by extensive studies.

 

Presented Macula Society, Singapore 2017, submitted to AJO 2017