Combining Hypo-Reflective Structural En Face Imaging Improves Polypoidal Lesion Detection on Spectral-Domain OCT Angiography.

IF 2.6 3区医学 Q2 OPHTHALMOLOGY

Translational Vision Science & Technology Pub Date : 2025-08-01 DOI:10.1167/tvst.14.8.12

Jianqing Li, Nana Xu, Huixun Jia, Xiaoling Wan, Fenghua Wang, Minwen Zhou, Mengxi Shen, Qiyu Bo, Xiaodong Sun

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引用次数: 0

Abstract

Purpose: The purpose of this study was to identify novel features on spectral-domain optical coherence tomography angiography (SD-OCTA) that improve detection of polypoidal lesions in polypoidal choroidal vasculopathy (PCV).

Methods: In this prospective study, 22 eyes from 20 patients with indocyanine green angiography (ICGA) confirmed PCV underwent same-day imaging with both SD-OCTA and swept-source OCTA (SS-OCTA). Images were independently reviewed, and blinded to ICGA and each other. Morphological features of polypoidal lesions were compared to establish combined diagnostic criteria to improve SD-OCTA detection, including hyper- or hypo-flow signals on angiographic en face images, circular hypo-reflective signals on structural en face images, and corresponding flow signals within retinal pigment epithelial detachments (PEDs) on B-scans. Hyporeflective signals on structural en face images were defined as well-circumscribed and low-reflectivity areas. Diagnostic accuracy was assessed using sensitivity, specificity, positive predictive value, negative predictive value, and area under the curve (AUC).

Results: ICGA identified 52 polypoidal lesions. SS-OCTA showed superior detection (98%) compared to SD-OCTA (69%) after manual segmentation correction. Hyporeflective signals on SD-OCTA structural en face images were observed in 73% of lesions, higher than SS-OCTA (52%). Applying combined criteria to SD-OCTA enabled detection of 8 additional lesions, raising the detection rate to 85% and diagnostic accuracy to 95%.

Conclusions: This combined approach significantly improves SD-OCTA diagnostic performance and is recommended in clinical practice, especially when standard retinal pigment epithelium (RPE) and Bruch's membrane (BM) segmentations were used.

Translational relevance: Identifying hyporeflective signals on structural en face SD-OCTA improves polypoidal lesion detection, enhancing the clinical utility of SD-OCTA in diagnosing PCV.

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结合低反射结构人脸成像提高了光谱域OCT血管造影对息肉病变的检测。

目的：本研究的目的是确定光谱域光学相干断层血管造影（SD-OCTA）的新特征，以提高对息肉样脉络膜血管病变（PCV）息肉样病变的检测。方法：在这项前瞻性研究中，来自20例经吲哚青绿血管造影（ICGA）证实PCV的患者的22只眼，在同一天进行SD-OCTA和扫源OCTA （SS-OCTA）成像。图像独立审查，并对ICGA和彼此盲化。比较息肉样病变的形态学特征，建立联合诊断标准以提高SD-OCTA的检测，包括血管造影面部图像上的高或低血流信号，结构性面部图像上的圆形低反射信号，以及b扫描上视网膜色素上皮脱落（PEDs）内相应的血流信号。结构面图像上的低反射信号被定义为边界良好的低反射率区域。通过敏感性、特异性、阳性预测值、阴性预测值和曲线下面积（AUC）评估诊断准确性。结果：ICGA检出息肉样病变52例。经过人工分割校正后，SS-OCTA的检出率（98%）高于SD-OCTA（69%）。73%的病变在SD-OCTA结构面图像上观察到低反射信号，高于SS-OCTA（52%）。应用SD-OCTA联合标准，可以检测到8个额外的病变，将检出率提高到85%，诊断准确率提高到95%。结论：这种联合方法显著提高了SD-OCTA的诊断性能，在临床实践中值得推荐，特别是在使用标准视网膜色素上皮（RPE）和布鲁赫膜（BM）分割时。翻译相关性：识别结构面SD-OCTA的低反射信号可提高息肉样病变的检测，提高SD-OCTA诊断PCV的临床应用价值。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Translational Vision Science & Technology Engineering-Biomedical Engineering

CiteScore

5.70

自引率

3.30%

发文量

346

审稿时长

25 weeks

期刊介绍： Translational Vision Science & Technology (TVST), an official journal of the Association for Research in Vision and Ophthalmology (ARVO), an international organization whose purpose is to advance research worldwide into understanding the visual system and preventing, treating and curing its disorders, is an online, open access, peer-reviewed journal emphasizing multidisciplinary research that bridges the gap between basic research and clinical care. A highly qualified and diverse group of Associate Editors and Editorial Board Members is led by Editor-in-Chief Marco Zarbin, MD, PhD, FARVO. The journal covers a broad spectrum of work, including but not limited to: Applications of stem cell technology for regenerative medicine, Development of new animal models of human diseases, Tissue bioengineering, Chemical engineering to improve virus-based gene delivery, Nanotechnology for drug delivery, Design and synthesis of artificial extracellular matrices, Development of a true microsurgical operating environment, Refining data analysis algorithms to improve in vivo imaging technology, Results of Phase 1 clinical trials, Reverse translational ("bedside to bench") research. TVST seeks manuscripts from scientists and clinicians with diverse backgrounds ranging from basic chemistry to ophthalmic surgery that will advance or change the way we understand and/or treat vision-threatening diseases. TVST encourages the use of color, multimedia, hyperlinks, program code and other digital enhancements.