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dc.contributor.authorVoraporn Chaikitmongkolen_US
dc.contributor.authorJun Kongen_US
dc.contributor.authorPreeyanuch Khunsongkieten_US
dc.contributor.authorDirek Patikulsilaen_US
dc.contributor.authorMira Sachdevaen_US
dc.contributor.authorPimploy Chavengsaksongkramen_US
dc.contributor.authorChutikarn Dejkriengkraikulen_US
dc.contributor.authorPawara Winaikosolen_US
dc.contributor.authorJanejit Choovuthayakornen_US
dc.contributor.authorNawat Watanachaien_US
dc.contributor.authorParadee Kunavisaruten_US
dc.contributor.authorThammasin Ingviyaen_US
dc.contributor.authorNeil M. Bressleren_US
dc.date.accessioned2019-08-05T04:40:23Z-
dc.date.available2019-08-05T04:40:23Z-
dc.date.issued2019-06-01en_US
dc.identifier.issn21686165en_US
dc.identifier.other2-s2.0-85064263762en_US
dc.identifier.other10.1001/jamaophthalmol.2019.0565en_US
dc.identifier.urihttps://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85064263762&origin=inwarden_US
dc.identifier.urihttp://cmuir.cmu.ac.th/jspui/handle/6653943832/65742-
dc.description.abstract© 2019 American Medical Association. All rights reserved. Importance: The use of indocyanine green angiography (ICGA) is a criterion standard for diagnosing polypoidal choroidal vasculopathy (PCV), an endemic and common cause of vision loss in Asian and African individuals that also presents in white individuals. However, the use of ICGA is expensive, invasive, and not always available at clinical centers. Therefore, knowing the value of certain features detected using fundus photography (FP), optical coherence tomography (OCT), and fluorescein angiography (FA) to diagnose PCV without ICGA could assist ophthalmologists to identify PCV when ICGA is not readily available. Objective: To explore the sensitivity, specificity, and predictive accuracy of potential diagnostic features detected using FP, OCT, and FA in diagnosing PCV without ICGA. Design, Setting, and Participants: Deidentified images of FP alone, OCT alone, and FA alone were graded by 3 retina specialists masked to ICGA findings for potentially diagnostic features of PCV prespecified before grading compared with the criterion standard grading of 2 other retina specialists with access simultaneously to FP, OCT, FA and ICGA. Specialists graded images of 124 eyes of 120 patients presenting between January 1, 2013, and December 31, 2016, with newly identified serous or serosanguinous maculopathy who had undergone FP, OCT, FA, and ICGA before treatment at a large referral eye center in Thailand. Main Outcomes and Measures: Sensitivity, specificity, positive predictive value, negative predictive value, and predictive accuracy from the area under the receiver operating characteristic curve (AUC). Results: The mean (SD) age of the patients was 57.7 (12.6) years, 52 were women, 68 were men, and the diagnosis (from ICGA) was PCV for 65 eyes (52.4%), central serous chorioretinopathy for 45 eyes (36.3%), and typical neovascular age-related macular degeneration for 12 eyes (9.7%). With the use of FP, a potential diagnostic feature for PCV was notched or hemorrhagic pigment epithelial detachment (AUC, 0.77; 95% CI, 0.70-0.85). With the use of OCT, potential diagnostic features for PCV were pigment epithelial detachment notch (AUC, 0.90; 95% CI, 0.85-0.96), sharply peaked pigment epithelial detachment (AUC, 0.86; 95% CI, 0.80-0.92), and a hyperreflective ring (AUC, 0.86; 95% CI, 0.80-0.92). When at least 2 of these 4 signs were present, the AUC was 0.93 (95% CI, 0.89-0.98), with a sensitivity of 0.95 (95% CI, 0.87-0.99), a specificity of 0.95 (95% CI, 0.82-0.97), a positive predictive value of 0.92 (95% CI, 0.83-0.97), and a negative predictive value of 0.95 (95% CI, 0.86-0.99). Conclusions and Relevance: These data suggest that the potential diagnostic features detected using FP and OCT provide high sensitivity and specificity for a diagnosis of PCV, especially when at least 2 of 4 highly suggestive signs are present.en_US
dc.subjectMedicineen_US
dc.titleSensitivity and Specificity of Potential Diagnostic Features Detected Using Fundus Photography, Optical Coherence Tomography, and Fluorescein Angiography for Polypoidal Choroidal Vasculopathyen_US
dc.typeJournalen_US
article.title.sourcetitleJAMA Ophthalmologyen_US
article.volume137en_US
article.stream.affiliationsThe Wilmer Eye Institute at Johns Hopkinsen_US
article.stream.affiliationsPrince of Songkla Universityen_US
article.stream.affiliationsChiang Mai Universityen_US
article.stream.affiliationsJournal of American Medical Associationen_US
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