Clinical Publications

MAESTRO

Comparison of macular neovascularization lesion size by the use of Spectral-Domain Optical Coherence Tomography Angiography and Swept Source Optical Coherence Tomography Angiography versus Indocyanine Green Angiography

AUTHORS:

Haas AM, Ahmed D, Stattin M, Graf A, Krepler K, Ansari-Shahrezaei S.

PUBLICATION:

Acta Ophthalmol. 2021 Mar;99(2):e260-e266. doi: 10.1111/aos.14572. Epub 2020 Aug 24

Study Purpose

To compare the lesion sizes of macular neovascularization (MNV) imaged with spectral-domain (SD), swept-source (SS) optical coherence tomography angiography (OCTA), and indocyanine green (ICGA)

Overview

Study Design

Prospective, observational case series

# of Eyes/
Patients

Twenty eyes from 20 patients with type 1, 2 or mixed type MNV secondary to age-related macular degeneration (AMD)

Study Device

Maestro2 SD-OCTA (Topcon Corporation, Tokyo, Japan) Triton™ SS-OCTA (Topcon Corporation, Tokyo, Japan) Spectralis® HRA, Heidelberg, Germany)

Outcome Measures

Primary outcome measure: comparison between MNV area in 6×6 mm2 images on SD-OCTA and SS-OCTA Secondary outcome measures: comparison of 3×3 mm2 images between the SD-OCTA and SS-OCTA, between OCTA and ICGA images, and sensitivity of both OCTA devices

Results

On 6×6-mm2 scans, SS-OCTA showed larger lesion sizes for MNV that were fully outlined compared to SD-OCTA (p = 0.094). Differences between SD-OCTA and ICGA measurements (p = 0.057) and SS-OCTA and ICGA lesion sizes (p = 0.274) were not significant
On 3×3-mm2 images, comparable MNV area sizes were measured between the two OCTA devices (p = 0.492) and no statistical significance was detected comparing SD-OCTA with ICGA (p = 0.278) and SS-OCTA with ICGA (p = 0.492)
Within the same OCTA device (Maestro2 or Triton), no statistical difference could be shown for MNV lesion size between 3×3-mm2 and 6×6-mm2 scans
Neovascular network was not detected in seven patients on SD-OCTA and three patients on SS-OCTA, while the presence of neovascularization was confirmed by ICGA in 100% of eyes. Hence, detection rate was 13/20 (65% sensitivity) for SD-OCTA and 17/20 (85% sensitivity) for SS-OCTA

IMOvifa reduced measurement time by

39%

Conclusions

• Compared to SD-OCTA, SS-OCTA may show larger areas of macular neovascularization extensions and better correlation to ICGA • The high identification of neovascular membranes on OCTA reduces the need to use FA and ICGA in clinical practice, reserving dye-based angiography for select patients, such as people with low visual acuity, bad fixation, or inconclusive OCTA findings