First Author: J.Chhablani INDIA
Co Author(s): D. MJ M. Tyagi R. Narayanan I. Kozak 0 0 0 0 0 0 0 0 0
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To assess intra/inter-observer agreement in making diagnosis of myopic choroidal neovascularization (CNV) on color fundus photograph (CFP), fluorescein angiography (FFA) and spectral-domain optical coherence tomography (SD-OCT) and correlate with presenting symptoms in subjects with suspected myopic CNV.
Tertiary Eye Care Center
Two masked observers evaluated FFA and SD-OCT images separately to diagnose the presence of myopic CNV in 80 eyes of 57 patients. A third masked observer diagnosed CNV on color fundus photo. Presence of myopic CNV on CFP was defined as presence of subretinal hemorrhage, thickening of retina and/ or visible membrane at the macula. Presence of myopic CNV on FFA was defined as hyperfluorescence in early phase with increase in intensity and size in the late phase; presence of large irregular lesion, hypofluorsescence due to subretinal hemorrhage. Myopic CNV on SD-OCT was defined as the hyperreflective lesion with or without intraretinal fluid or subretinal fluid with retinal thickening.
Intraobserver repeatability on FFA and SD-OCT was 0.54 and 0.44 respectively. Agreement (Kappa) between FFA and SD-OCT was 0.38 and 0.3 respectively. Out of 43 symptomatic eyes, CNV on CFP was present in 53.4% eyes; on FFA in 51.1% eyes and on SD-OCT in 41.8% eyes. Sensitivity and specificity of FFA was 47% and 80.4% respectively and that SD-OCT was 58.8% and 86.9% respectively.
Repeatability and reproducibility for diagnosis of myopic CNV was better with FFA compared to SD-OCT, however, agreement is very poor between FFA and SD-OCT. SD-OCT is comparatively better tool to rule out presence of myopic CNV.