Purpose
To evaluate the utility of SDOCT during ocular telescreening compared to fundus photography.
Methods
Self-reported normal subjects with no systemic or ocular disease were prospectively included during telemedicine eye screening in Newark, NJ. A predetermined comprehensive screening protocol included visual acuity, non-contact tonometry, non-mydriatic 12 mega pixel fundus color imaging (Canon CX-1 Hybrid Retinal camera), and SDOCT (Canon HS100). Demographic data was collected. All images were acquired without dilation and viewed on a computer with a resolution of 1280x800 in a dark room. Positive and normal findings on SDOCT and color images were logged and compared. Patients with positive findings were referred for ophthalmology care.
Results
Eighty subjects, one hundred and sixty eyes were imaged. Mean age was 52 yrs, range 23-77 yr, 42.5% males and 57.5% females. Sixteen subjects (20%) were identified as having abnormal findings by SDOCT or color imaging (Table). Sixty four subjects (80%) had a normal screening by both imaging modalities. Optic nerve and macula pathology was noted in eight (10%) and six (7.5%) subjects, respectively. Findings were diagnosed on SDOCT alone in (12/80) 15%, fundus imaging alone in (5/80) 6.3%, and both in (2/80) 2.5% of subjects. There were no cases in which OCT analysis could not be obtained. In three cases (3.8%), the quality of the fundus photograph was poor and precluded sufficient analysis for pathology either due to presence of cataract, size of pupil or other technical reasons. In four cases (5%), the optic nerve only, but not the macula could be evaluated on fundus imaging. In three cases (3.8%), the fundus image was read as normal, while macula OCT analysis revealed abnormalities in the fovea. RNFL loss was identified on OCT and not on fundus imaging in six cases (7.5%).
Conclusions
Integrating SDOCT during ocular screening was useful in the detection of macular pathology and RNFL loss compared to fundus imaging. All cases with RNFL loss were only detected on SDOCT, not fundus imaging. The role of SDOCT in ocular screening deserves further study.
Keywords: 550 imaging/image analysis: clinical •
465 clinical (human) or epidemiologic studies: systems/equipment/techniques •
610 nerve fiber layer