Ability of novice clinicians to use the high resolution ocular coherence tomography to assess lesions of the ocular surface

Abstract

Purpose : To assess the ability of novice clinicians to use the high resolution anterior segment ocular coherence tomography (HR-OCT) to diagnose various lesions of the ocular surface and cornea

Methods : 26 black and white HR-OCT images were projected and clinicians were asked to determine whether the lesions represented ocular surface squamous neoplasia (OSSN) or another ocular surface pathology. A 20-minute instructional lecture was then given on how to read HR-OCT images and the same 26 images were shown. The clinicians were then asked to repeat their assessment of the lesions.

Results : The mean frequency of correct identification of the 26 lesions was 70% (standard deviation 15%) prior to instruction and after a short lecture, the frequency of correct identification improved to 84% (SD 9%), p=0.002. On average, novice clinicians were more accurate in correctly determining that a lesion was not an OSSN over determining that a lesion was an OSSN (p=0.001). Some lesions (both OSSN and not OSSN), however, were more difficult to interpret than others.

Conclusions : This study demonstrates that HR-OCT can aid novice clinicians in identifying lesions as being or not being an OSSN.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

 

A classic image of an OSSN on HR HR-OCT. All features of OSSN (epithelial thickening, hyperreflectivity, and abrupt transition (arrow) from normal to abnormal epithelium) are seen.

 

A more subtle image of OSSN on HR HR-OCT. Note only subtle epithelial thickening. The lesion is highly hyper-reflective and an abrupt transition is seen on the conjunctival side (arrow), but less defined on the corneal side.