Use of optical coherence tomography angiography for the diagnosis of age-related macular degeneration.

ABSTRACT

INTRODUCTION: Age-related macular degeneration (AMD) causes approximately 9% of all blindness worldwide. The introduction of optical coherence tomography angiography (OCT-A) has revealed a potential for non-invasive diagnosis of neovascular AMD (nAMD), but has yet to be proven an accurate method for nAMD diagnosis. The purpose of this study was to map the clinical use of OCT-A in nAMD diagnosis and to investigate the agreement between two consultants in diagnosing nAMD. METHODS: A survey was administered to assess Danish ophthalmologists in nAMD diagnostic modalities. Furthermore, a prospective observational cohort study was conducted in which two consultants graded Triton and Heidelberg OCT-A in patients with suspected nAMD. RESULTS: A total of 21 ophthalmologists completed the survey. OCT-A combined with structural OCT was the first choice for the majority (81%), whereas dye-based ophthalmic angiography was used when in doubt of the diagnosis. OCT-A was used to guide treatment decisions in 64% of patients. Some ophthalmologists (48%) had no formal OCT-A training. In the second part of the study, an agreement was recorded between the two consultants in 86% of the cases with Triton OCT-A and 66% with Heidelberg OCT-A. CONCLUSIONS: OCT-A with structural OCT has become a primary diagnostic method of nAMD, but national guidelines are lacking. Future implementation of new diagnostic technology of nAMD should include trial-based guidelines and physician training. FUNDING: None. TRIAL REGISTRATION Not relevant.