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Ehsan Rahimy, Murtaza K Adam, Nadim Rayess, Joseph Maguire, Jason Hsu; Radial versus raster spectral-domain optical coherence tomography scan patterns for detection of neovascular age-related macular degeneration pathology. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):1649.
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To compare the effectiveness the 12-line radial scan pattern to the standard 25-line raster in detecting intraretinal/subretinal fluid in neovascular age-related macular degeneration (AMD).
Retrospective observational series of patients with neovascular AMD imaged between December 2013 and May 2014. A total of 200 eyes that underwent Heidelberg SD-OCT image acquisition using both 12-line radial and 25-line raster patterns were evaluated by two independent graders. All scans included in the study had subretinal/intraretinal fluid present in at least one of the acquisition patterns. Manual measurements were also performed to evaluate eccentricity from the foveal center of missed fluid on either scan protocol.
A total of 394 SD-OCT scans were interpreted (mean: 1.97 scans/eye). The 12-line radial detected fluid in all but 7 scans (1.7%; 95% CI 0.7-3.6%), resulting in a sensitivity of 98.3%. The 25-line raster identified fluid in all but 10 scans (2.5%; 95% CI 1.2-4.6%), resulting in a sensitivity of 97.5% (Figure 2). The difference in fluid detection between the patterns was not statistically significant (P=0.6276). The majority of 25-line raster scans which failed to detect fluid were intraretinal (70%), while the majority of 12-line radial scans that missed fluid were subretinal (57.2%) in location. Subgroup analysis was performed to determine whether foveal eccentricity impacted the 25-line raster or 12-line radial scan pattern's ability to detect fluid. Of the ten 25-line raster scans which missed fluid, the average distance from the foveal center to the pathology by the 12-line radial scan was 779.5 ± 682.1 µm. In contrast, of the seven 12-line radial scans which missed fluid, the average distance from the foveal center on the 25-line raster scan was 1402 ± 1297 µm. The difference in average distance from the foveal center on 12-line radial compared to 25-line raster demonstrated a trend towards statistical significance (P=0.056).
The SD-OCT 12-line radial scan is statistically comparable to the 25-line raster scan in detecting the presence of intraretinal/subretinal fluid in neovascular AMD. The 12-line radial pattern alone may be adequate to guide day-to-day clinical decisions in a more time-efficient manner.
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