July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Swept Source Optical Coherence Tomography Compared to B-Scan Ultrasonography and Biomicroscopy to Diagnose Posterior Vitreous Detachment
Author Affiliations & Notes
  • Marlene Wang
    Ophthalmology, Columbia College of Physicians and Surgeons, New York, New York, United States
  • Cecile Truong
    Ophthalmology, Columbia College of Physicians and Surgeons, New York, New York, United States
  • S. Amal Hussnain
    Ophthalmology, Columbia College of Physicians and Surgeons, New York, New York, United States
  • Zaid Mammo
    Ophthalmology, Columbia College of Physicians and Surgeons, New York, New York, United States
  • Royce W.S. Chen
    Ophthalmology, Columbia College of Physicians and Surgeons, New York, New York, United States
  • Footnotes
    Commercial Relationships   Marlene Wang, None; Cecile Truong, None; S. Hussnain, None; Zaid Mammo, None; Royce Chen, Allergan (C), Carl Zeiss Meditec Inc. (C)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 1877. doi:
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      Marlene Wang, Cecile Truong, S. Amal Hussnain, Zaid Mammo, Royce W.S. Chen; Swept Source Optical Coherence Tomography Compared to B-Scan Ultrasonography and Biomicroscopy to Diagnose Posterior Vitreous Detachment. Invest. Ophthalmol. Vis. Sci. 2019;60(9):1877.

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

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Abstract

Purpose : Biomicroscopy and B-scan ultrasound imaging are still considered the gold standard for the diagnosis of a posterior vitreous detachment (PVD) regardless of growing evidence that swept source - optical coherence tomography (SS-OCT) produces high quality images of the vitreo-retinal interface. We performed a prospective, observational study to compare the rate of diagnosis of PVD by biomicroscopy, B-scan ultrasound imaging, and SS-OCT, as well as the agreement between the diagnostic modalities.

Methods : We examined 95 eyes of 48 consecutive patients with biomicroscopy, B-scan ultrasound, and SS-OCT (16-mm horizontal line scan including the optic nerve and macula) for the presence or absence of a complete PVD (PVD status). Patients aged 18 years or older were included in the study. Eyes with a media opacity (i.e. dense cataract or vitreous hemorrhage) or that had undergone a previous vitrectomy were excluded from the study. One retina specialist (RWSC) evaluated all eyes by biomicroscopy and B-scan ultrasonography. All SS-OCT images were reviewed in a blinded fashion by 2 retina specialists and evaluated for agreement by Cohen’s kappa statistic. Additionally, agreement among the three diagnostic modalities was calculated using Cohen’s kappa statistic.

Results : Agreement on PVD status between SS-OCT and biomicroscopy was 85.3% (k = 0.711), and agreement between SS-OCT and B-scan ultrasound was 83.2% (k = 0.667). Agreement between B-scan ultrasound and biomicroscopy was 87.4% (k = 0.743). The inter-rater reliability between retina specialists reading the SS-OCT images was 97.9% (k = 0.957). In the 16 cases where there were disagreements between SS-OCT and B-Scan, the SS-OCT images were reviewed and found to provide more detailed information that could definitively determine presence (13/16) or absence (3/16) of PVD.

Conclusions : SS-OCT produces high quality images of the vitreo-retinal interface and is non-inferior to the current gold standard (B-scan and ultrasound) for the diagnosis of PVD. Additionally, SS-OCT allows for high reproducibility and agreement of observations between graders. Given the rapidity and ease of acquisition of SS-OCT in patients with clear media, SS-OCT can reliably be used to evaluate PVD status in future studies.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

 

A complete PVD seen with SS-OCT imaging that was not detected by B-Scan ultrasound imaging or biomicroscopy.

A complete PVD seen with SS-OCT imaging that was not detected by B-Scan ultrasound imaging or biomicroscopy.

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