TY - JOUR
T1 - Comparison Between Graders in Detection of Diabetic Neovascularization With Swept Source Optical Coherence Tomography Angiography and Fluorescein Angiography
AU - Al-khersan, Hasenin
AU - Russell, Jonathan F.
AU - Lazzarini, Thomas A.
AU - Scott, Nathan L.
AU - Hinkle, John W.
AU - Patel, Nimesh A.
AU - Yannuzzi, Nicolas A.
AU - Fowler, Benjamin J.
AU - Hussain, Rehan M.
AU - Barikian, Anita
AU - Sridhar, Jayanth
AU - Russell, Stephen R.
AU - Haddock, Luis J.
AU - Smiddy, William E.
AU - Hariprasad, Seenu M.
AU - Shi, Yingying
AU - Wang, Liang
AU - Feuer, William
AU - Gregori, Giovanni
AU - Rosenfeld, Philip J.
N1 - Funding Information:
Hasenin Al-khersan is a resident at the Bascom Palmer Eye Institute where he will stay on as a vitreoretinal surgical fellow and chief resident. His research has been supported by the Vitreoretinal Surgery Foundation, Fight for Sight, and the Illinois Society for the Prevention of Blindness.
Funding Information:
Research was supported by grants from Carl Zeiss Meditec (Dublin, California), an unrestricted grant from Research to Prevent Blindness, Inc. (New York, New York), and National eye Institute Center Core grant P30EY014801 to the Department of Ophthalmology, University of Miami Miller School of Medicine. The funding organizations had no role in the design or conduct of this research. All authors have completed and submitted the ICMJE form for disclosure of potential conflicts of interest. Financial Disclosures: N.A.Y. is an advisory board member at Alimera Sciences, Genentech, and Novartis. R.M.H. is an advisory board member at Alimera Sciences. J.S. is a consultant for Alcon Laboratories, Alimera Sciences, and Allergan. S.R.R. received research support from Spark Therapeutics and ProQR, is a consultant for Novartis, and is a cofounder of and holds equity in IDx Technologies. S.M.H. is a consultant or on the Speaker's Bureau for EyePoint Pharmaceuticals, Allergan, Alimera Sciences, Novartis, Spark, Biogen, Clearside Biomedical, and Regeneron. G.G. and P.J.R. have received research support from Carl Zeiss Meditec, Inc. G.G. and the University of Miami co-own a patent assigned to Carl Zeiss Meditec, Inc. P.J.R. has received research support from Stealth BioTherapeutics and is also a consultant for Apellis, Biogen, Boehringer-Ingelheim, Carl Zeiss Meditec, Chengdu Kanghong Biotech, EyePoint, Ocunexus Therapeutics, Ocudyne, and Unity Biotechnology. P.J.R. also has equity interest in Apellis, Valitor Verana Health, and Ocudyne. The remaining authors indicate no financial support or conflicts of interest. All authors attest that they meet the current ICMJE criteria for authorship.
Publisher Copyright:
© 2020
PY - 2021/4
Y1 - 2021/4
N2 - Purpose: We compared the ability of ophthalmologists to identify neovascularization (NV) in patients with proliferative diabetic retinopathy using swept-source optical coherence tomography angiography (SS-OCTA) and fluorescein angiography (FA). Design: Retrospective study comparing diagnostic instruments. Methods: Eyes with proliferative diabetic retinopathy or severe nonproliferative diabetic retinopathy and a high suspicion of NV based on clinical examination were imaged using SS-OCTA and FA at the same visit. Two separate grading sets consisting of scrambled, anonymized SS-OCTA and FA images were created. The ground truth for presence of NV was established by consensus of 2 graders with OCTA experience who did not participate in the subsequent assessment of NV in this study. The 2 anonymized image sets were graded for presence or absence of NV by 12 other graders that included 2 residents, 6 vitreoretinal fellows, and 4 vitreoretinal attending physicians. The percentage of correct grading of NV using SS-OCTA and FA was assessed for each grader and across grader training levels. Results: Forty-seven eyes from 24 patients were included in this study. Overall, the mean percentage of correct NV grading was 87.8% using SS-OCTA with B-scans and 86.2% using FA (P = .92). Assessing each grader individually, there was no statistically significant asymmetry in correct grading using SS-OCTA and FA. Conclusions: Ophthalmologists across training levels were able to identify diabetic NV with equal accuracy using SS-OCTA and FA. Based on these results, SS-OCTA may be an appropriate standalone modality for diagnosing diabetic NV.
AB - Purpose: We compared the ability of ophthalmologists to identify neovascularization (NV) in patients with proliferative diabetic retinopathy using swept-source optical coherence tomography angiography (SS-OCTA) and fluorescein angiography (FA). Design: Retrospective study comparing diagnostic instruments. Methods: Eyes with proliferative diabetic retinopathy or severe nonproliferative diabetic retinopathy and a high suspicion of NV based on clinical examination were imaged using SS-OCTA and FA at the same visit. Two separate grading sets consisting of scrambled, anonymized SS-OCTA and FA images were created. The ground truth for presence of NV was established by consensus of 2 graders with OCTA experience who did not participate in the subsequent assessment of NV in this study. The 2 anonymized image sets were graded for presence or absence of NV by 12 other graders that included 2 residents, 6 vitreoretinal fellows, and 4 vitreoretinal attending physicians. The percentage of correct grading of NV using SS-OCTA and FA was assessed for each grader and across grader training levels. Results: Forty-seven eyes from 24 patients were included in this study. Overall, the mean percentage of correct NV grading was 87.8% using SS-OCTA with B-scans and 86.2% using FA (P = .92). Assessing each grader individually, there was no statistically significant asymmetry in correct grading using SS-OCTA and FA. Conclusions: Ophthalmologists across training levels were able to identify diabetic NV with equal accuracy using SS-OCTA and FA. Based on these results, SS-OCTA may be an appropriate standalone modality for diagnosing diabetic NV.
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U2 - 10.1016/j.ajo.2020.11.020
DO - 10.1016/j.ajo.2020.11.020
M3 - Article
C2 - 33309812
AN - SCOPUS:85100805594
VL - 224
SP - 292
EP - 300
JO - American Journal of Ophthalmology
JF - American Journal of Ophthalmology
SN - 0002-9394
ER -