Use of optical coherence tomography, fluorescein angiography and indocyanine green angiography in a screening clinic for wet age-related macular degeneration.
OBJECTIVE
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).


METHODS
Retrospective audit of a consecutive series of 134 new patients referred with suspected wet AMD. When visual acuity was >or=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.
Talks
James
J
Department of Ophthalmology, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP, UK. james.talks@newcastle.ac.uk
Koshy
Zachariah
Z
Chatzinikolas
Konstantinos
K
D000368:Aged; D000369:Aged, 80 and over; D004396:Coloring Agents; D005260:Female; D005451:Fluorescein Angiography / Q000379:methods* / Q000592:standards; D006801:Humans; D007208:Indocyanine Green; D008268:Macular Degeneration / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D041623:Tomography, Optical Coherence / Q000379:methods* / Q000592:standards; D015351:Vision Screening / Q000379:methods
D004396:Coloring Agents; D007208:Indocyanine Green