Lacquer Cracks Detection and Measurement Using Black-on-White Infrared Reflectance and Late-Phase Indocyanine Green...

The aim of this study is to compare the detection and quantification of lacquer cracks (LCs) using 2 imaging methods: indocyanine green angiography (ICGA) and black-on-white infrared reflectance (bwIR).

Retrospective single-center study.

Myopic patients diagnosed with LCs at the Department of Ophthalmology of the University Paris Est Créteil.

Medical records and multimodal imaging, including bwIR and ICGA, of myopic patients aged >18 years with LCs were reviewed. Two independent graders evaluated the presence of LCs in bwIR images and on late-phase ICGA. Image processing was used to segment and compute the area of LCs on bwIR and ICGA.

Evaluation and comparison of the rate of detection of LCs on bwIR and late-phase ICGA. Comparison between the extent of LCs detected by bwIR and with late-phase ICGA.

Thirty-two (32) eyes of 22 patients (13 women, 9 men) with a mean age of 54.95 ± 18.7 years were included in this study. Graders detected LCs on bwIR images in 29/32 analyzed cases (90.6% sensitivity, 95% CI: 75%-98%), whereas they detected LCs in 32/32 cases in ICGA images (100% sensitivity). Agreement between graders in detection was very good (Cohen κ = 0.78). The mean area of the LCs detected in bwIR images was 14.58 ± 8.21 mm², whereas the mean area of the LCs in ICGA was 13.86 ± 8.50 mm². This difference was not statistically significant in paired analysis (P = 0.73).

In this study, we propose rapid and noninvasive bwIR as a valid and promising noninvasive screening tool for detection of LCs and quantifying their extension.

Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.