Author: Paolo Milani (Italy)
Co-authors: Marco Mazzola, Alessandro Falcione, Francesca Toto, Stefano Ciaccia, Stefania Moschini, Fulvio Bergamini
Purpose
To evaluate the sensitivity of a spectral-domain optical coherence tomography (SD-OCT) biomarker, the choroidal shadowing, in active myopic choroidal neovascularization (mCNV). This finding is typically caused by the tissue density of the neovascular complex that leads to the tomographic hypo-transmission from the retina toward the choroid.
Setting/Venue
This retrospective, cross-sectional study was based in IRCCS Istituto Auxologico Italiano, Milan, Italy.
Methods
The clinical and imaging parameters of eyes with high myopia (spherical equivalent of -6D or less) with naïve or recurrent mCNV were reviewed independently by two investigators. A control group with inactive mCNV was included, too. The presence of mCNV was based on multimodal imaging that included fluorescein angiography and SD-OCT findings. When available, OCT angiography was also used. Presence of choroidal hypo-transmission was defined as the shadowing of the retinal lesion projected toward the underlying choroid on SD-OCT. The shadowing enables distinguishment of the adjacent, unaffected choroid from the underneath choroid masked by the lesion
Results
Eighty-three eyes (27 men, 56 women) with active mCNV were included in the study. The mean patient age was 67,69 years (range, 39–89 years) with a mean of -10.02 diopters (range -6, -24). In the control group 30 eyes (10 men, 20 women) with fibrotic mCNV were included. The mean patient age was 65,06 years (range 44-89) with a mean of -11,7 (range -6,-20). Fifty-two eyes with active mCNV presented choroidal shadowing in correspondence of the lesion resulting in a sensitivity of 63%. Twelve eyes with fibrotic mCNV presented choroidal shadowing too, thus resulting in a specificity of 60%. The concordance between the investigators was good (Cohen’s k factor = 0.80).
Conlusions
In active mCNV, choroidal shadowing is a tomographic biomarker with a limited positive and negative predictive value.
Financial Disclosure
No financial relations to diclose
Comments
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