Diagnostic ability of wide field swept source optical coherence tomography in glaucoma

Abstract

Purpose: Deep Range Imaging Optical Coherence Tomography (DRI-OCT) is a new swept-source device that provides the ability to image a large retinal area (12 x 9 mm) in a single scan. The purpose of this study was to evaluate the diagnostic ability of wide-field DRI-OCT in glaucoma.

Methods: A cross-sectional observational study of 172 glaucomatous eyes of 117 subjects and 96 eyes of 57 healthy subjects enrolled in the Diagnostic Innovations in Glaucoma Study. Glaucoma was defined by the presence of ≥2 consecutive abnormal standard automated perimetry results or progressive glaucomatous change on masked grading of stereophotographs. Global and sectorial retinal nerve fiber layer (RNFL) thickness were assessed using DRI-OCT. Area under the receiver operating characteristic curves (AROC) were calculated to determine the ability of DRI-OCT to differentiate glaucomatous and healthy eyes.

Results: The average DRI-OCT global RNFL thickness (entire 12 x 9 mm scan) was 51.5 ± 6.5 μm in healthy eyes versus 35.6 ± 9.9 μm in glaucoma (P < 0.001). Average DRI-OCT peripapillary RNFL thickness was 104.6 ± 17.2 μm and 68.7 ± 22.8 μm in healthy and glaucomatous eyes (P < 0.001), respectively. DRI-OCT global RNFL thickness had an AUC of 0.88, which was similar to peripapillary RNFL thickness using the Spectralis OCT circle scan (AROC of 0.88). The best performing parameter was DRI-OCT RNFL thickness of the temporal retina (AROC = 0.90).

Conclusions: DRI-OCT is a promising new technology in the diagnosis of glaucoma that allows imaging of a wide retinal area using a single scan protocol.

Keywords: 552 imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • 550 imaging/image analysis: clinical • 610 nerve fiber layer