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Journal of Ophthalmology
Volume 2017, Article ID 3479695, 7 pages
https://doi.org/10.1155/2017/3479695
Research Article

Sensitivity, Specificity, and Limitations of Optical Coherence Tomography Angiography in Diagnosis of Polypoidal Choroidal Vasculopathy

Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan

Correspondence should be addressed to Shih-Jen Chen; moc.liamg@69nehcjs

Received 20 August 2017; Accepted 14 November 2017; Published 12 December 2017

Academic Editor: Talisa E. de Carlo

Copyright © 2017 Yi-Ming Huang et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose. To evaluate the sensitivity and specificity of optical coherence tomography angiography (OCTA) in differentiating polypoidal choroidal vasculopathy (PCV) from age-related macular degeneration (AMD). Methods. Fundus color photographs, spectral-domain optical coherence tomography, and fluorescein angiography (step 1) and OCTA (step 2) of 50 eyes that had PCV or AMD were presented to two ophthalmologists. The final diagnoses of PCV were masked. Sensitivity and specificity were calculated and compared to the 2-step approach (before and after OCTA) in detecting PCV. The limitations were also evaluated. Results. Of the 50 eyes, 31 were PCV and 19 were non-PCV. The sensitivity increased from 69.5% to 90% after OCTA; however, there was no significant improvement in specificity after OCTA. 70.9% of the eyes with PCV had clear or obvious branching vascular nets (BVNs) in OCTA with high sensitivity (97.5%) after OCTA. Contrarily, 29.1% had insignificant BVNs with a low sensitivity (72.5%) after OCTA. 27% of the occult choroidal neovascularization (CNV) cases were overdiagnosed as PCV when OCTA was applied. Conclusions. OCTA based on clear BVNs at the choroidal level increased sensitivity of diagnosis of PCV by 20%. However, the false-positive rate also increased in occult CNV. Several limitations for a correct diagnosis of PCV were noted.