Purpose:To compare the intermodality and interreader agreement for geographic atrophy (GA) lesion size quantification in green-light fundus autofluorescence (GAF; excitation = 518 nm) versus combined blue-light fundus autofluorescence (BAF; excitation = 488 nm) and near-infrared reflectance (NIR; 820 nm) -based grading.
Methods:Confocal scanning laser ophthalmoscopy (cSLO) GAF, BAF, and NIR images of 40 eyes from 29 patients (mean age 79.7 years) with GA secondary to AMD were recorded according to a standardized protocol. GA areas were analyzed in GAF, BAF combined with NIR (BAF+NIR), or BAF alone, by four independent readers using semiautomated software (RegionFinder; Heidelberg Engineering, Heidelberg, Germany). A mixed-effects model was used to assess the effect of image modality on the measured square-root lesion area. The coefficient of repeatability (CR) and intraclass correlation coefficient (ICC) were assessed for the square-root lesion area, lesion perimeter, and circularity.
Results:GAF-based measurements were on average 0.062 mm (95% confidence interval [CI] 0.04-0.08 mm) larger than BAF+NIR-based measurements and 0.077 mm (95% CI 0.06 - 0.10 mm) larger than BAF-based measurements. Interreader agreement was highest for GAF-based analysis ([CR, ICC] 0.196 mm, 0.995) followed by BAF+NIR (0.232 mm, 0.992) and BAF alone (0.263 mm, 0.991). The same was noted for the lesion perimeter and circularity. Post hoc review revealed that interreader differences were associated with media opacification interfering with lesion boundary demarcation to a larger extent in BAF than in GAF.
Conclusions:cSLO-based GAF and combined BAF+NIR imaging with semiautomated lesion delineation allow for an accurate and reproducible quantification of GA. The slightly better interreader agreement using cSLO GAF suggests that its use may be preferable in clinical trials examining the change in lesion size as a clinical endpoint.
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【Green-Light Autofluorescence Versus Combined Blue-Light Autofluorescence and Near-Infrared Reflectance Imaging in Geographic Atrophy Secondary to Age-Related Macular Degeneration.].
【绿光自发荧光与结合蓝光自发荧光和近红外反射成像在继发于与年龄有关的黄斑变性的地理萎缩中。】
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DOI：10.1167/iovs.17-21764文章类型：杂志文章
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目的：比较绿光眼底自发荧光（GAF；激发= 518 nm）与蓝光眼底自发荧光（BAF；激发= 488 nm）和近-基于红外反射率（NIR; 820 nm）的分级。
方法：按照标准方案记录29例年龄平均为79.7岁，继发于AMD的GA患者的40只眼的椎间扫描激光检眼镜（cSLO）GAF，BAF和NIR图像。四个独立的读者使用半自动化软件（RegionFinder； Heidelberg Engineering，Heidelberg，Germany），在GAF，BAF与NIR（BAF NIR）结合或单独使用BAF中分析了GA区域。使用混合效应模型来评估图像模态对所测量的平方根病变区域的影响。对平方根病变面积，病变周长和圆度评估了重复性系数（CR）和组内相关系数（ICC）。
结果：基于GAF的测量值比基于BAF NIR的测量值平均大0.062 mm（95％置信区间[CI] 0.04-0.08 mm），比基于BAF的测量值大0.077 mm（95％CI 0.06-0.10 mm）。基于GAF的分析（[CR，ICC] 0.196 mm，0.995）的阅读器间协议最高，其次是BAF NIR（0.232 mm，0.992）和单独的BAF（0.263 mm，0.991）。病变周长和圆形度也相同。事后审查显示，与GAF相比，BAF中阅读者之间的差异与媒介混浊干扰病灶边界的程度更大。
结论：基于cSLO的GAF以及结合BAF NIR成像和半自动病变描述，可以对GA进行准确且可重复的定量。使用cSLO GAF的阅读器之间的协议稍好，这表明在临床研究中（病灶大小变化作为临床终点）可能更可取。
方法：按照标准方案记录29例年龄平均为79.7岁，继发于AMD的GA患者的40只眼的椎间扫描激光检眼镜（cSLO）GAF，BAF和NIR图像。四个独立的读者使用半自动化软件（RegionFinder； Heidelberg Engineering，Heidelberg，Germany），在GAF，BAF与NIR（BAF NIR）结合或单独使用BAF中分析了GA区域。使用混合效应模型来评估图像模态对所测量的平方根病变区域的影响。对平方根病变面积，病变周长和圆度评估了重复性系数（CR）和组内相关系数（ICC）。
结果：基于GAF的测量值比基于BAF NIR的测量值平均大0.062 mm（95％置信区间[CI] 0.04-0.08 mm），比基于BAF的测量值大0.077 mm（95％CI 0.06-0.10 mm）。基于GAF的分析（[CR，ICC] 0.196 mm，0.995）的阅读器间协议最高，其次是BAF NIR（0.232 mm，0.992）和单独的BAF（0.263 mm，0.991）。病变周长和圆形度也相同。事后审查显示，与GAF相比，BAF中阅读者之间的差异与媒介混浊干扰病灶边界的程度更大。
结论：基于cSLO的GAF以及结合BAF NIR成像和半自动病变描述，可以对GA进行准确且可重复的定量。使用cSLO GAF的阅读器之间的协议稍好，这表明在临床研究中（病灶大小变化作为临床终点）可能更可取。
