Santiago Montolío-Marzo, Roberto Gallego Pinazo, Elena Palacios-Pozo, Rosa Dolz-Marco
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A grading tool was designed to classify these cases using standard OCT images (contrast value: 12) followed by reassessment with contrast-modified OCT images (contrast value: 1).</p><p><strong>Results: </strong>Thirty-seven ophthalmologists were involved: four 1st-year trainees, four 2nd-year trainees, four 3rd-year trainees, 12 4th-year trainees, and 13 consultants from different subspecialties. Average result for correct classification was 13.16 using standard images alone and 14.22 using contrast-modified images showing a significant improvement (<i>P</i> = 0.01). The accuracy was greater for type 1 lesions when using contrast-modified images, whereas there was no improvement with type 2 and 3 lesions (<i>P</i> = 0.039, <i>P</i> = 0.835, <i>P</i> = 0.193). The average correct answers was greater for type 2 (<i>µ</i> = 5.08) than type 1 (<i>µ</i> = 5.08) and type 3 (<i>µ</i> = 2) (<i>P</i> = 0.046). The graders (<i>n</i>; %) classified the utility of contrast-modified images as essential (1; 2,7%), very useful (29; 78.4%), indifferent (5; 13.5%), not very useful (1; 2.7%) and useless (1; 2.7%).</p><p><strong>Conclusions: </strong>In challenging cases, it might be easier to locate the retinal pigment epithelium (RPE), evaluate RPE integrity, classify MNV, and study subretinal hyperreflective material using contrast enhanced OCT images. The accuracy for MNV classification increases with contrast-modified images in type 1 MNV. It is an accessible tool that could show even better performance as the ophthalmologist gains more experience using it.</p>","PeriodicalId":19679,"journal":{"name":"Ophthalmic surgery, lasers & imaging retina","volume":" ","pages":"540-544"},"PeriodicalIF":1.1000,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"New Method to Facilitate Tomographic Macular Neovascularization Classification in Age-related Macular Degeneration.\",\"authors\":\"Santiago Montolío-Marzo, Roberto Gallego Pinazo, Elena Palacios-Pozo, Rosa Dolz-Marco\",\"doi\":\"10.3928/23258160-20250717-02\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background and objective: </strong>Evaluation of contrast-modified optical coherence tomography (OCT) images as a tool for better macular neovascularization (MNV) classification in age-related macular degeneration (AMD) cases.</p><p><strong>Patients and methods: </strong>Twenty-five OCT images obtained with SPECTRALIS (Heidelberg Engineering GmbH) from patients showing MNV (10 type 1, 10 type 2, and 5 type 3) were selected. Two retina specialists (RDM and RGP) classified the MNV lesions and then the same cases were classified by 37 ophthalmologists with different degree of training. A grading tool was designed to classify these cases using standard OCT images (contrast value: 12) followed by reassessment with contrast-modified OCT images (contrast value: 1).</p><p><strong>Results: </strong>Thirty-seven ophthalmologists were involved: four 1st-year trainees, four 2nd-year trainees, four 3rd-year trainees, 12 4th-year trainees, and 13 consultants from different subspecialties. Average result for correct classification was 13.16 using standard images alone and 14.22 using contrast-modified images showing a significant improvement (<i>P</i> = 0.01). The accuracy was greater for type 1 lesions when using contrast-modified images, whereas there was no improvement with type 2 and 3 lesions (<i>P</i> = 0.039, <i>P</i> = 0.835, <i>P</i> = 0.193). The average correct answers was greater for type 2 (<i>µ</i> = 5.08) than type 1 (<i>µ</i> = 5.08) and type 3 (<i>µ</i> = 2) (<i>P</i> = 0.046). The graders (<i>n</i>; %) classified the utility of contrast-modified images as essential (1; 2,7%), very useful (29; 78.4%), indifferent (5; 13.5%), not very useful (1; 2.7%) and useless (1; 2.7%).</p><p><strong>Conclusions: </strong>In challenging cases, it might be easier to locate the retinal pigment epithelium (RPE), evaluate RPE integrity, classify MNV, and study subretinal hyperreflective material using contrast enhanced OCT images. The accuracy for MNV classification increases with contrast-modified images in type 1 MNV. 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引用次数: 0
摘要
背景与目的：对比校正光学相干断层扫描（OCT）图像作为一种更好的黄斑新生血管（MNV）分类工具在年龄相关性黄斑变性（AMD）病例中的评价。患者和方法：选择由SPECTRALIS （Heidelberg Engineering GmbH）从MNV患者（10例1型，10例2型，5例3型）获得的25张OCT图像。两名视网膜专家（RDM和RGP）对MNV病变进行分类，然后由37名不同培训程度的眼科医生对相同病例进行分类。设计分级工具，使用标准OCT图像（对比度值：12）对这些病例进行分类，然后使用对比度修改后的OCT图像（对比度值：1）进行重新评估。结果：共纳入37名眼科医师，其中1年实习医师4名，2年实习医师4名，3年实习医师4名，4年实习医师12名，专科医师13名。单独使用标准图像正确分类的平均结果为13.16，对比修改图像的平均结果为14.22，有显著提高（P = 0.01）。对比修正图像对1型病变的准确率更高，而对2型和3型病变的准确率没有提高（P = 0.039, P = 0.835, P = 0.193）。类型2（µ= 5.08）的平均正确答案大于类型1（µ= 5.08）和类型3（µ= 2）（P = 0.046）。评分者(n；%)将对比度修改图像的效用分类为必不可少的(1；2.7%)，非常有用(29%；78.4%)，无所谓(5；13.5%)，不是很有用(1；2.7%)和无用(1；2.7%)。结论：在具有挑战性的病例中，使用对比增强OCT图像可能更容易定位视网膜色素上皮（RPE），评估RPE完整性，分类MNV，并研究视网膜下高反射物质。1型MNV的分类精度随着对比度的提高而提高。这是一种易于使用的工具，随着眼科医生使用它的经验越来越丰富，它可以显示出更好的性能。
New Method to Facilitate Tomographic Macular Neovascularization Classification in Age-related Macular Degeneration.
Background and objective: Evaluation of contrast-modified optical coherence tomography (OCT) images as a tool for better macular neovascularization (MNV) classification in age-related macular degeneration (AMD) cases.
Patients and methods: Twenty-five OCT images obtained with SPECTRALIS (Heidelberg Engineering GmbH) from patients showing MNV (10 type 1, 10 type 2, and 5 type 3) were selected. Two retina specialists (RDM and RGP) classified the MNV lesions and then the same cases were classified by 37 ophthalmologists with different degree of training. A grading tool was designed to classify these cases using standard OCT images (contrast value: 12) followed by reassessment with contrast-modified OCT images (contrast value: 1).
Results: Thirty-seven ophthalmologists were involved: four 1st-year trainees, four 2nd-year trainees, four 3rd-year trainees, 12 4th-year trainees, and 13 consultants from different subspecialties. Average result for correct classification was 13.16 using standard images alone and 14.22 using contrast-modified images showing a significant improvement (P = 0.01). The accuracy was greater for type 1 lesions when using contrast-modified images, whereas there was no improvement with type 2 and 3 lesions (P = 0.039, P = 0.835, P = 0.193). The average correct answers was greater for type 2 (µ = 5.08) than type 1 (µ = 5.08) and type 3 (µ = 2) (P = 0.046). The graders (n; %) classified the utility of contrast-modified images as essential (1; 2,7%), very useful (29; 78.4%), indifferent (5; 13.5%), not very useful (1; 2.7%) and useless (1; 2.7%).
Conclusions: In challenging cases, it might be easier to locate the retinal pigment epithelium (RPE), evaluate RPE integrity, classify MNV, and study subretinal hyperreflective material using contrast enhanced OCT images. The accuracy for MNV classification increases with contrast-modified images in type 1 MNV. It is an accessible tool that could show even better performance as the ophthalmologist gains more experience using it.
期刊介绍：
OSLI Retina focuses exclusively on retinal diseases, surgery and pharmacotherapy. OSLI Retina will offer an expedited submission to publication effort of peer-reviewed clinical science and case report articles. The front of the journal offers practical clinical and practice management features and columns specific to retina specialists. In sum, readers will find important peer-reviewed retina articles and the latest findings in techniques and science, as well as informative business and practice management features in one journal.
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