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C Gustavo De Moraes, Jeffrey M Liebmann, Jeremy Reimann, Lam Lu, Lama Al-Aswad, Dana Blumberg, George A Cioffi, Robert Ritch, Donald Hood; The Macula Progression Study (MAPS): Repeatability of a Single, Wide-field, Swept-Source Optical Coherence Tomography Protocol. Invest. Ophthalmol. Vis. Sci. 2017;58(8):4258.
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© ARVO (1962-2015); The Authors (2016-present)
Commercially-available software for detecting progression with OCT do not employ a reference database with patient data repeated over short intervals to help differentiate progression from variability. We have described and validated a single wide-field swept-source optical coherence tomography (ssOCT) protocol to diagnose early glaucoma. To test the feasibility of using this single scan protocol to detect the progression of glaucoma, we assessed the repeatability of its measures.
In this prospective cohort study, we included 124 eyes (124 subjects (52 healthy controls; 16 glaucoma suspects; and 56 early manifest glaucoma) with 24-2 mean deviation (MD) > -6 dB). All participants had ssOCT wide-field scans (9x12 mm, DRI-OCT, Topcon, Inc., Tokyo, Japan) and 24-2 and 10-2 visual field tests on the same day, which were repeated at least four times within an 8 week period. For quantitative analysis, we calculated the 90% limits of variability of local and global macular retinal ganglion cell plus inner plexiform layer (RGC+) and circumpapillary retinal nerve fiber layer (cpRNFL) thicknesses. Changes exceeding the upper 5% and 1% limits are deemed “possible” and “likely” progression, respectively. For qualitative analysis, two expert graders reviewed all sequential images to assess the repeatability of the single wide-field ssOCT report.
The repeatability of RGC+ and cpRNFL thickness measurements was excellent (ICC= 0.96 and 0.98, respectively). The expert grader did not flag any significant changes in participants’ reports over time using the repeatability data. Figure 1 depicts an example of a patient with double arcuate scotomata affecting the macula. The wide-field reports of tests performed 4 weeks apart were very similar.
Given its excellent repeatability, a single wide-field ssOCT report may be useful not only to diagnose early glaucoma, but also to detect early signs of structural progression.REFERENCE1. Hood et al., TVST 2016:5(6):4
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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