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"Triple-Layer Sign": An OCT Signature for the Detection of Non-Exudative Macular Neovascularization
TAKE-HOME MESSAGE
- In this study, the authors investigated the utility of the "triple-layer sign" (TLS) in diagnosing non-exudative macular neovascularization (NE-MNV) in patients with age-related macular degeneration. Optical coherence tomography was performed to identify three layers (retinal pigment epithelium, neovascular tissue, and Bruch's membrane). Overall, 40 of 130 eyes demonstrated evidence of NE-MNV. The TLS was observed in 39 of 40 patients with NE-MNV, compared with 8 of 90 patients in the control group. The overall sensitivity of the TLS for diagnosing NE-MNV was 91%, with a specificity of 97%. Inter-rater agreement for the identification of the TLS was also high.
- The TLS may represent a valuable diagnostic tool for the identification of NE-MNV in patients with age-related macular degeneration.
abstract
This abstract is available on the publisher's site.
Access this abstract nowPURPOSE
To assess the sensitivity and specificity of the "triple layer sign" (TLS) (retinal pigment epithelium (RPE), neovascular tissue, and Bruch's membrane) on structural optical coherence tomography (OCT) images for the diagnosis of treatment-naïve non-exudative type-1 macular neovascularization (NE-MNV) in age-related macular degeneration (AMD).
DESIGN
Cross-sectional study.
METHODS
Two masked retinal experts evaluated the presence of the TLS in eyes with NE-MNV and controls with an RPE elevation without exudation due to other causes than NE-MNV in AMD [e.g., medium-large drusen, cuticular drusen, basal laminar deposits (BlamD)].
RESULTS
130 eyes of 98 consecutive patients met the study criteria; 40 eyes of 40 patients satisfied the criteria for being included in the NE-MNV secondary to AMD group (27 females, 13 males, with a mean age of 73.8 ± 8.0 years), and 90 eyes of 58 patients met the criteria to be included in the control group (31 eyes were included in the medium-to-large drusen sub-group, 32 eyes in the cuticular drusen sub-group, and 27 eyes in the BlamD group. The TLS was observed in 39/40 patients with NE-MNV and 8/90 controls. The sensitivity and specificity of the TLS for the diagnosis of NE-MNV were 97% and 91%, respectively.
CONCLUSIONS
The TLS on OCT demonstrated high sensitivity and specificity values in detecting treatment-naive type 1 NE-MNV.
Additional Info
The "triple-layer sign": an optical coherence tomography signature for the detection of non-exudative macular neovascularization
Graefes Arch. Clin. Exp. Ophthalmol 2024 Dec 01;262(12)3847-3855, V Capuano, R Sacconi, A Miere, E Borrelli, F Amoroso, E Costanzo, M Parravano, S Fragiotta, F Bandello, EH Souied, G QuerquesFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.