Self-Examination Low-Cost Full-Field OCT (SELFF-OCT) for Age-Related Macular Degeneration

Abstract

Purpose : Self-Examination Low-Cost Full-Field Optical Coherence Tomography (SELFF-OCT) is a novel OCT technology that was specifically designed for home monitoring of age-related macular degeneration (AMD). First clinical findings have been reported before [1]. This trial investigates an improved prototype for AMD patients and focusses on device operability and diagnostic accuracy compared with established spectral-domain OCT (SD-OCT).
[1] von der Burchard C et al. Self-examination low-cost full-field OCT (SELFF-OCT) for patients with various macular diseases. Graefes Arch Clin Exp Ophthalmol, 2020, DOI: 10.1007/s00417-020-05035-6.

Methods : We performed a cross-sectional study in patients with age-related macular degeneration. Patients received short training in device handling and then performed multiple self-scans with the SELFF-OCT according to a predefined protocol. Additionally, all eyes were examined with standard SD-OCT, performed by medical personnel. All images were graded in a reading center by at least 2 blinded investigators for different biomarkers and the necessity of anti-VEGF treatment.

Results : In total, 85 eyes of 45 patients with AMD were measured with SELFF-OCT. Compared to prior prototypes, advancements in technology and an improved patient interface enhanced image quality and reduced motion artifacts. In 86% of all examined eyes, OCT self-acquisition resulted in interpretable retinal OCT volume scans. In these patients, the sensitivity for detection of anti-VEGF treatment indication was 0.94 [confidence interval 0.79-0.99] and specificity 0.95 [0.82-0.99]. Sensitivity and specificity for the detection of single biomarkers were 0.9/0.98 for subretinal fluid, 0.57/0.95 for intraretinal fluid and 0.76/0.95 for pigment epithelium detachment.

Conclusions : SELFF-OCT was used successfully for retinal self-examination in most patients, and it could become a valuable tool for retinal home-monitoring in the future. Improvements are in progress to reduce device size and to improve handling, image quality and success rates.

This is a 2021 ARVO Annual Meeting abstract.