title: Sensitivity and specificity of spectral-domain optical coherence tomography in detecting idiopathic polypoidal choroidal vasculopathy.
abstract: OBJECTIVE
  To evaluate the efficacy of spectral-domain optical coherence tomography (SD OCT) compared to indocyanine green angiography (ICGA) in detecting idiopathic polypoidal choroidal vasculopathy (PCV) and in differentiating between PCV and occult choroidal neovascularization (CNV).
  
  
  METHODS
  Retrospective observational case-control study.
  
  
  METHODS
  SD OCTs of 51 eyes of 44 consecutive patients who presented with 1 or more pigment epithelial detachments (PEDs) attributable to either PCV or occult CNV were retrospectively reviewed by a grader masked to the final diagnosis. A qualitative analysis based on the following tomographic findings was performed: sharp PED peak, PED notch, hyporeflective lumen within hyperreflective lesions adherent to retinal pigment epithelium. The diagnosis based on SD OCT alone was compared with the final diagnosis made using ICGA and fluorescein angiography. Sensitivity and specificity were calculated. Patients with classic CNV and central serous chorioretinopathy were excluded.
  
  
  RESULTS
  Among 51 eyes of 44 patients, 37 had an ICGA-confirmed diagnosis of PCV and 14 had occult CNV. SD OCT based on the features above detected 35 of 37 true-positive PCV lesions but missed 2 ICGA-confirmed lesions (false negatives). SD OCT correctly excluded 13 of 14 non-PCV lesions but misidentified 1 PCV lesion (false positive). These data showed a sensitivity of 94.6% and a specificity of 92.9% for the above SD OCT features in identifying PCV lesions.
  
  
  CONCLUSIONS
  SD OCT based on the features above allowed for good detection of PCV and differentiation between PCV and occult CNV in this selected clinic population. A careful qualitative analysis of the tomographic findings in patients presenting with PEDs may allow ophthalmologists to distinguish between PCV and occult CNV, decreasing the need for ICGA and the risks related to this procedure.
authors.affiliation: Medical Retina Department, Moorfields Eye Hospital National Health Service Foundation Trust; and National Institute of Health Research Biomedical Research Centre at Moorfields Eye Hospital National Health System Foundation Trust and University College London Institute of Ophthalmology, London, United Kingdom. Electronic address: gabrydsl@tiscali.it.
authors.forename: Gabriella
authors.initials: G
authors.lastname: De Salvo
authors.affiliation: Medical Retina Department, Moorfields Eye Hospital National Health Service Foundation Trust; and National Institute of Health Research Biomedical Research Centre at Moorfields Eye Hospital National Health System Foundation Trust and University College London Institute of Ophthalmology, London, United Kingdom.
authors.forename: Sara
authors.initials: S
authors.lastname: Vaz-Pereira
authors.affiliation: Medical Retina Department, Moorfields Eye Hospital National Health Service Foundation Trust; and National Institute of Health Research Biomedical Research Centre at Moorfields Eye Hospital National Health System Foundation Trust and University College London Institute of Ophthalmology, London, United Kingdom.
authors.forename: Pearse A
authors.initials: PA
authors.lastname: Keane
authors.affiliation: Medical Retina Department, Moorfields Eye Hospital National Health Service Foundation Trust; and National Institute of Health Research Biomedical Research Centre at Moorfields Eye Hospital National Health System Foundation Trust and University College London Institute of Ophthalmology, London, United Kingdom.
authors.forename: Adnan
authors.initials: A
authors.lastname: Tufail
authors.affiliation: Medical Retina Department, Moorfields Eye Hospital National Health Service Foundation Trust; and National Institute of Health Research Biomedical Research Centre at Moorfields Eye Hospital National Health System Foundation Trust and University College London Institute of Ophthalmology, London, United Kingdom.
authors.forename: Gerald
authors.initials: G
authors.lastname: Liew
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D002829:Choroid / Q000098:blood supply; D020256:Choroidal Neovascularization / Q000175:diagnosis*; D004396:Coloring Agents; D005189:False Positive Reactions; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007208:Indocyanine Green; D008297:Male; D008875:Middle Aged; D011127:Polyps / Q000175:diagnosis*; D011237:Predictive Value of Tests; D055213:Retinal Pigment Epithelium / Q000473:pathology; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D041623:Tomography, Optical Coherence
chemical_list: D004396:Coloring Agents; D007208:Indocyanine Green