相干光断层扫描血管成像对病理性近视脉络膜新生血管诊断价值的研究

The application of optical coherence tomography angiography in assessment of choroidal neovascularization secondary to pathologic myopia

目的研究相干光断层扫描血管成像(optical coherence tomography angiography,OCTA)对病理性近视继发性脉络膜新生血管形成(choroidal neovascularization,CNV)的诊断价值。设计诊断方法评价。研究对象北京同仁医院眼科临床诊断的病理性近视CNV患者40例。方法患者接受荧光素眼底血管造影(fundus fluorescein angiography,FFA)及OCTA检查。以FFA诊断为金标准,计算OCTA诊断病理性CNV的敏感性和特异性。采用Kappa检验评价OCTA与FFA对病理性近视CNV活动性判读的一致性。主要指标敏感性、特异性、Kappa值。结果OCTA诊断病理性近视CNV的敏感性为96.7%,特异性为100%。两种检查方法对病理性近视CNV活动性判读的一致性Kappa值为0.502(P<0.001),一致性程度中等。结论OCTA能够高敏感高特异性的判定病理性近视性CNV,但对病理性近视CNV活动性的判断与FFA一致性中等。

Objective To estimate the ability of OCTA in detecting choroiodal neovascularization(CNV)secondary to pathologic myopia and to assess the ability of OCTA in assessment of the activity of CNV compared to fundus fluorescein angiography(FFA).Design Diagnostic method evaluation.Participants 40 eyes with clinical diagnosis of CNV secondary to pathologic myopia in Beijing Tongren Eye Center.Methods All the eyes underwent FFA and OCTA respectively.The diagnosis of CNV and the judgment of CNV activity were compared between FFA and OCTA.Main Outcome Measures The sensitivity and specificity of OCTA,and Kappa value.Results The sensitivity and specificity of OCTA for choroidal neovascularization secondary to pathologic myopia were 96.7%and 100%respectively.The agreement for grading of CNV activity between OCTA and FFA was moderate(Kappa=0.502,P<0.001).Conclusion OCTA demonstrate high sensitivity and specificity for detection of CNV secondary to pathological myopia,while with a moderate ability of grading CNV activity.