摘要： Purpose: Structural optical coherence tomography (OCT) images from eyes with non-exudative age-related macular degeneration (AMD) were graded for the presence of a double layer sign to determine if the double-layer sign predicted subclinical macular neovascularization (MNV). Design: Prospective, observational study. Participants: Non-exudative AMD patients with and without subclinical MNV identified by swept source OCT angiography (SS-OCTA). Methods: Subjects were enrolled prospectively into a SS-OCTA imaging study. A set of test scans with and without subclinical MNV was compiled to assess the ability of trained graders to identify non-exudative type 1 MNV. The graders only evaluated the structural OCT B-scans of those eyes. The presence of a double-layer sign was used as a predictive sign for subclinical type 1 MNV. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) from two separate gradings were calculated and compared. Main Outcome Measures: The association between the presence of a double-layer sign and subclinical type 1 MNV. Results: One hundred eyes with non-exudative AMD from 94 patients were used for this study. The test set contained 64 eyes with intermediate AMD (iAMD), which included 20 eyes with subclinical MNV, and 36 eyes with late AMD, which included 13 eyes with subclinical MNV. Two junior graders read the scans separately then reached a consensus grading. They detected a double-layer sign in 24 out of 33 eyes with subclinical MNV and did not detect a double-layer sign in 56 out of 67 eyes without MNV. Their sensitivity, specificity, PPV, and NPV were 73%, 84%, 69%, and 86%, respectively. The senior grader detected a double-layer sign in 29 out of 33 eyes with subclinical MNV and did not detect a double-layer sign in 58 out of 67 eyes without MNV, achieving a sensitivity, specificity, PPV, and NPV as 88%, 87%, 76%, and 94%, respectively. For all graders, there were statistically significant associations between the type 1 MNV and the double-layer sign (P < 0.001). Conclusions: The double-layer sign on structural OCT B-scans was associated with subclinical type 1 MNV and can be used to identify these lesions with good predictive values in eyes with non-exudative AMD.