Abstract
Purpose :
While Ocular Coherence Tomography (OCT) is a potentially valuable tool for disease identification in community mobile screening programs (CMSP), its performance in this setting remains poorly understood. We sought to test the hypothesis that OCT image capturing in the CMSP setting meets or exceeds scan quality index (SQI) standards.
Methods :
We performed a cross-sectional study in 22 CMSP settings around Oregon from 2022-2023. Diagnostic testing included on site Visionx (formerly Optovue) OCT operated by either an ophthalmic technician or trained volunteer. Diagnoses of glaucoma and diabetic retinopathy were made by ophthalmologists conducting in-person confirmatory dilated eye exams after the OCTs were completed. OCT performance was evaluated for internal reliability using Visionx manufacturer guidelines (ONH SQI>26, GCC SQI>31). We employed a linear regression analysis to assess the relationship between age and SQI values in participants with diagnoses of optic nerve and retinal disease, and unpaired t-tests were conducted to compare mean SQI differences between values obtained by technicians versus volunteers.
Results :
OCT images passed internal reliability standards in 94% and 94.9% of participants for ONH and GCC, respectively. The average SQI rating for ONH and GCC of images captured on eyes with optic nerve and retinal disease was similar across racial, ethnic, and age groups. Linear regression analysis showed a very weak negative correlation (R2 = 0.14) between age and SQI value. SQI values passing the Visionx threshold were found in OCT images captured by both trained OCT technicians (μ=61.0, n=145, SD=13.4) and clinic volunteers (μ=58.6, n=47, SD=11.3.). Given p values of 0.7967 and 0.1383 for ONH and GCC, respectively, there were no statistical differences in the SQI values of images captured by OCT technicians versus clinic volunteers trained on the day of screening.
Conclusions :
Our results demonstrate that OCT performance within a CMSP setting is acceptable when evaluated by SQI, and comparable to ophthalmology clinical settings. The SQI does not appear to have a strong dependence on expertise of the OCT operator which suggests that formally trained technician staffing is not a significant barrier to OCT use. Further study into OCT accessibility could offer improved guidance on its utility in the CMSP setting.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.