Use of optical coherence tomography, fluorescein angiography and indocyanine green angiography in a screening clinic for wet age-related macular degeneration. Issue 5 (6th December 2006)

• Record Type: Journal Article
• Authors: Talks, James; Koshy, Zachariah; Chatzinikolas, Konstantinos
• Is Part Of: British journal of ophthalmology. Volume 91:Issue 5(2007)
• Page Start: 600
• Page End: 601
• Publication Date: 2006-12-06
• Subjects: AMD, age-related macular degeneration -- CNV, choroidal neovascular membrane -- FFA, fundus fluorescein angiography -- HRA, Heidelberg retina angiograph -- ICGA, indocyanine green angiography -- OCT, optical coherence tomography -- PCV, polypoidal choroidal vasculopathy -- PDT, photodynamic therapy -- PED, pigment epithelial detachment -- RAP, retinal angiomatous proliferation; Ophthalmology -- Periodicals; 617.7
• DOI: 10.1136/bjo.2006.108043
• Languages: English
• ISSNs: 0007-1161

Abstract

Abstract : Aims: To assess the utility of optical coherence tomography (OCT) in a nurse-led, fast-track clinic for new age-related macular degeneration (AMD) referrals, and to see how often indocyanine green angiography (ICGA) led to an additional diagnosis to that provided by fundus fluorescein angiography (FFA). Method: Retrospective audit of a consecutive series of 134 new patients referred with suspected wet AMD. When visual acuity was ⩾6/60 an OCT was performed. If the OCT was consistent with "wet" AMD, the patient underwent simultaneous FFA/ICGA. The sensitivity and specificity of this clinic was calculated. The number of additional diagnoses made using ICGA was recorded. Results: 23/134 (17.16%) patients had OCT only and were not subsequently found to have wet AMD. FFA/ICGA was performed in 111 patients, showing wet AMD in 90 (81%) patients. OCT as used in our clinic had a sensitivity of 1 and a specificity of 0.65 for detecting wet AMD. ICGA provided additional diagnoses in 19 (14.17%) patients. ICGA detected a specific vascular abnormality in 58% of the occult lesions. Conclusions: OCT proved to be an effective screening tool for wet AMD in this clinic, with excellent sensitivity and reasonable specificity. ICGA provided an additional diagnosis in a significant number of cases, but did not define a vascular abnormality in all occult cases.