July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018

Low-Cost Home-Care OCT for AMD with Off-Axis Full-Field Time-Domain OCT – Analysis of Reliability and Feasibility in Disease Monitoring
Author Affiliations & Notes
  • Claus von der Burchard
    Department of Ophthalmology, University of Kiel, Kiel, Germany
  • Jan Tode
    Department of Ophthalmology, University of Kiel, Kiel, Germany
  • Stefan Otto Johannes Koinzer
    Department of Ophthalmology, University of Kiel, Kiel, Germany
  • Christoph Ehlken
    Department of Ophthalmology, University of Kiel, Kiel, Germany
  • Felix Treumer
    Department of Ophthalmology, University of Kiel, Kiel, Germany
  • Peter Koch
    Medizinisches Laserzentrum Lübeck, Lübeck, Germany
  • Helge Sudkamp
    Medizinisches Laserzentrum Lübeck, Lübeck, Germany
  • Reginald Birngruber
    Medizinisches Laserzentrum Lübeck, Lübeck, Germany
  • Gereon Hüttmann
    Medizinisches Laserzentrum Lübeck, Lübeck, Germany
  • Johann Roider
    Department of Ophthalmology, University of Kiel, Kiel, Germany
  • Footnotes
    Commercial Relationships   Claus von der Burchard, None; Jan Tode, None; Stefan Koinzer, None; Christoph Ehlken, None; Felix Treumer, None; Peter Koch, None; Helge Sudkamp, None; Reginald Birngruber, None; Gereon Hüttmann, None; Johann Roider, None
  • Footnotes
    Support  BMBF Grant 13N13766
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 4484. doi:
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    • Get Citation

      Claus von der Burchard, Jan Tode, Stefan Otto Johannes Koinzer, Christoph Ehlken, Felix Treumer, Peter Koch, Helge Sudkamp, Reginald Birngruber, Gereon Hüttmann, Johann Roider;
      Low-Cost Home-Care OCT for AMD with Off-Axis Full-Field Time-Domain OCT – Analysis of Reliability and Feasibility in Disease Monitoring. Invest. Ophthalmol. Vis. Sci. 2018;59(9):4484.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Home-care OCT monitoring of AMD could improve early relapse recognition while cutting down the frequency of office appointments. This might improve treatment outcome, reduce disease burden and possibly cut down over-all disease management costs. However, so far no means has been found that can accomplish sufficient diagnostic accuracy at the cost limit of home-care solutions.
With Off-Axis Full-Field Time-Domain OCT (OA-FF-TD-OCT), our group has proposed an OCT technology that has the potential to be sold for less than 1.000 USD. However, in contrast to clinically used SD-OCT systems, the field of view is limited to about 4.5 x 1.5 mm and resolution and signal-to-noise ratio (SNR) are reduced.
With ever increasing quality of OCT imaging, the question which performance is actually needed for AMD diagnostic follow-up examinations is unanswered. Therefore, we performed detailed analysis about minimum requirements for reliable AMD monitoring. Furthermore, we analysed possibilities for automated analysis of the obtained imaging.

Methods : First, we digitally degraded clinical high-quality OCT volume scans to be reduced in field of view, resolution and SNR to mimic the retinal images obtained by OA-FF-TD-OCT. Both original and degraded images were graded by a retina specialist and results were compared.
Furthermore, we retrospectively analysed OCT volume scans of AMD patients with respect to different biomarkers to determine their respective sensitivity and specificity in detecting disease activity.

Results : In an analysis of 88 degraded OA-FF-TD-OCT mimicking volume scans, sensitivity for detecting disease activity was 98% and specificity was 100%, when compared to the original scan.
In an analysis of 764 volume scans, the following sensitivities/specificities for different biomarkers were found: Presence of subretinal fluid (SRF) 70%/100%; intraretinal fluid (IRF) 65%/82%; pigment epithelium detachment (PED) 95%/11%; either SRF or IRF 99%/82%. Changes in retinal volume could detect disease relapse with 90%/87%.

Conclusions : OA-FF-TD-OCT allows cost-reduction while still providing image quality sufficient for AMD diagnostics. Biomarker and volume change detection are feasible approaches for automated evaluation. We are currently testing the device on AMD patients.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

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