Visualization of Type-1 Macular Neovascularization Secondary to Pachychoroid Spectrum Diseases: A Comparative Study for Sensitivity and Specificity of Indocyanine Green Angiography and Optical Coherence Tomography Angiography

Abstract

Background: The aim of this study was to compare optical coherence tomography angiography (OCTA) and indocyanine green angiography (ICGA) in detecting type-1 macular neovascularization (MNV) in pachychoroid spectrum diseases. Methods: Patients with pachychoroid characteristics who had undergone ICGA and OCTA imaging at the same visit, were recruited. The diagnosis of MNV was made by a senior retina specialist using multimodal imaging techniques. Afterward, both ICGA and OCTA images were separately reviewed by a masked-independent senior retina specialist with regard to the presence of MNV. The specificity, sensitivity, positive, and negative predictive values of ICGA and OCTA were analyzed. Results: OCTA was able to detect MNV with 97.2% sensitivity, failing to detect MNV only in one eye. The sensitivity of ICGA to detect MNV was 66.76%. The negative predictive value of OCTA was 94.7%; however, this value was 60% for ICGA. Multimodal imaging and OCTA were in almost perfect agreement (kappa coefficient = 0.95). Conclusion: OCTA shows greater sensitivity when detecting type-1 MNV than ICGA in pachychoroid neovasculopathy cases. OCTA is a non-invasive and quick imaging modality that can be preferred to dye angiography in the visualization of type-1 MNV in pachychoroid neovasculopathy.