Abstract
To determine if macular thickness maps (MTMs) are sufficient to guide management of eyes with exudative age-related macular degeneration (eAMD), we compared the ability to detect change using MTMs with the ability to detect change using the entire OCT scan in patients undergoing therapy.
Retrospective, comparative diagnostic analysis METHODS: Patients with eAMD were imaged using macula centered 6 × 6 mm OCT scans (CIRRUS HD-OCT 5000, ZEISS, Dublin, CA). In each case, graders were asked to determine if there were changes that warranted a full clinical assessment after viewing two consecutive scans using one of three different imaging strategies: MTMs alone, individual foveal centered B-scans alone, or 5 macular B-scans including the foveal-centered B-scan. Graders were told the two scans were taken two weeks apart. The consensus ground truth was reached by the graders using a CIRRUS review station to evaluate all the information contained within the OCT scans.
A total of 53 eyes were included in this study with 1385 imaging sessions. The Fleiss kappa was highest when graders were given MTMs alone compared with the ground truth. When the averages of all 5 graders were compared with the ground truth, the MTMs alone showed the highest level of agreement (90.05%; SD: 0.78%) followed by the central B-scans (87.87%; SD: 1.59%) and the five B-scan method (86.512%; SD: 0.64%).
MTMs alone provide sufficient information to easily identify recurrent exudation in patients with eAMD, and these maps may be all that is needed for remote monitoring.
