Noninvasive multimodal imaging in diagnosing polypoidal choroidal vasculopathy

Area of Science:

• Ophthalmology
• Medical Imaging
• Retinal Diseases

Background:

• Polypoidal choroidal vasculopathy (PCV) and neovascular age-related macular degeneration (nvAMD) are leading causes of vision loss.
• Accurate differentiation between PCV and nvAMD is crucial for effective treatment selection.

Purpose of the Study:

• To evaluate the diagnostic accuracy of noninvasive multimodal imaging for PCV.
• To distinguish PCV from typical nvAMD using imaging features.

Main Methods:

• Retrospective analysis of imaging data from 103 eyes with PCV or nvAMD.
• Utilized fundus photography (FP), B-scan optical coherence tomography (OCT), en face OCT, OCT angiography, and autofluorescence.
• Developed and validated a diagnostic strategy based on specific imaging features.

Main Results:

• Key features for PCV diagnosis included subretinal orange nodules (FP), thumb-like or notched pigment epithelial detachment (PED), bubble sign, and Bruch's membrane depression under PED (OCT).
• The diagnostic strategy achieved 0.88 sensitivity and 0.92 specificity for PCV diagnosis.
• Validation testing confirmed high diagnostic performance with 0.94 sensitivity and 0.93 specificity.

Conclusions:

• Noninvasive multimodal imaging, particularly FP and B-scan OCT, offers high diagnostic accuracy for PCV.
• The presence of at least two characteristic imaging features reliably distinguishes PCV from nvAMD.