Multimodal imaging for quantifying atrophic lesions in pathologic myopia
摘要
To assess the reliability and agreement of four imaging modalities in quantifying patchy atrophy in highly myopic (HM) eyes.
MethodsAtrophy area was manually delineated by two independent graders and measured using an in-built feature with four imaging modalities: infrared imaging with OCT B-scan (IR + SD-OCT), blue-light fundus autofluorescence (BAF), ultra-wide-field (UWF) pseudocolor fundus photography (PCFP) and UWF green fundus autofluorescence (GAF). Intragrader, intergrader and interdevice agreements were then assessed.
ResultsThirty-two eyes of 30 patients were included. The mean axial length was 30.31 ± 1.56 mm. From 128 analyzed images, the best intragrader repeatability was observed with IR + SD-OCT for both graders (ICC = 0.998 and 0.999), followed by BAF (ICC = 0.998 and 0.997), UWF PCFP (ICC = 0.992 and 0.999) and UWF GAF (ICC = 0.967 and 0.985). IR + SD-OCT was also superior in terms of intergrader repeatability (ICC = 0.999), followed by ICC = 0.998 for BAF, ICC = 0.996 for UWF PCFP, and ICC = 0.985 for UWF GAF. The atrophy areas measured using each device correlated (r = 0.958–0.995; all p < 0.001), but differed significantly (p < 0.001). PCFP and BAF measured respectively the smallest and largest median area (2.14 mm² [IQR: 3.88 mm²] and 2.90 mm² [IQR: 5.28 mm²], respectively). A larger lesion size was associated with greater interdevice disagreement.
ConclusionAll imaging modalities provided reliable atrophy area measurements, which correlated but differed significantly. IR + SD-OCT showed the strongest agreement.