title: Fluorescein angiography and optical coherence tomography in myopic choroidal neovascularization.
abstract: OBJECTIVE
  To assess intra/inter-observer agreement, and diagnostic capabilities of a color fundus photograph, fundus fluorescein angiography (FFA), and spectral domain optical coherence tomography (SD-OCT) in making a diagnosis of myopic choroidal neovascularization (CNV).
  
  
  METHODS
  Two masked observers evaluated FFA and SD-OCT images to identify the presence of myopic CNV in 80 high-myopic eyes of 57 patients. A third masked observer identified CNV on a color fundus photo. Presence of myopic CNV on a fundus photo was defined as presence of subretinal hemorrhage, thickening of the retina and/or visible membrane at the macula. Presence of myopic CNV on FFA was defined as hyperfluorescence in the early phase with increase in intensity and size in the late phase; presence of a large irregular lesion; and hypofluorsescence due to subretinal hemorrhage. Myopic CNV on SD-OCT was defined as the hyper-reflective lesion with or without intraretinal fluid or subretinal fluid with retinal thickening.
  
  
  RESULTS
  Intraobserver repeatability on FFA and SD-OCT was 0.54 and 0.44, respectively. Agreement (kappa) between FFA and SD-OCT was 0.38 and 0.3, respectively. Among 34 eyes, which had the presence of CNV on a color fundus photo, CNV was diagnosed in 18 (53%) eyes on FFA and in 20 (58.8%) eyes on SD-OCT. Sensitivity and specificity of FFA was 47 and 80.4%, respectively, and that of SD-OCT was 58.8 and 86.9%, respectively.
  
  
  CONCLUSIONS
  Repeatability and reproducibility for diagnosis of myopic CNV was better with FFA compared with SD-OCT; however, agreement is very poor between FFA and SD-OCT. SD-OCT is comparatively a better tool to rule out presence of myopic CNV.
authors.affiliation: Srimati Kanuri Santhamma Vitreo-Retina Service, L.V. Prasad Eye Institute, Hyderabad, India.
authors.forename: J
authors.initials: J
authors.lastname: Chhablani
authors.affiliation: Srimati Kanuri Santhamma Vitreo-Retina Service, L.V. Prasad Eye Institute, Hyderabad, India.
authors.forename: M J
authors.initials: MJ
authors.lastname: Deepa
authors.affiliation: Srimati Kanuri Santhamma Vitreo-Retina Service, L.V. Prasad Eye Institute, Hyderabad, India.
authors.forename: M
authors.initials: M
authors.lastname: Tyagi
authors.affiliation: Srimati Kanuri Santhamma Vitreo-Retina Service, L.V. Prasad Eye Institute, Hyderabad, India.
authors.forename: R
authors.initials: R
authors.lastname: Narayanan
authors.affiliation: Division of Vitreoretinal Diseases and Surgery, King Khaled Eye Specialist Hospital, Riyadh, Kingdom of Saudi Arabia.
authors.forename: I
authors.initials: I
authors.lastname: Kozak
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020256:Choroidal Neovascularization / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D008297:Male; D008875:Middle Aged; D047728:Myopia, Degenerative / Q000175:diagnosis* / Q000473:pathology; D015588:Observer Variation; D010781:Photography; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D041623:Tomography, Optical Coherence / Q000379:methods*; D055815:Young Adult