A Comparison Of Retinal Imaging Features Throughout Six Optical Coherence Tomography Devices
Published 2023 - 41st Congress of the ESCRS
Reference: FP31.05 | Type: Free paper | DOI: 10.82333/acjm-y905
Authors: Klaudia Kostolna* 1 , Gregor Reiter 1 , Sophie Frank 1 , Leonard M. Coulibaly 2 , Philipp Fuchs 2 , Veronika Röggla 1 , Markus Gumpinger 3 , Virginia Mares 4 , Hrvoje Bogunovic 3 , Ursula Schmidt-Erfurth 1
1Department of Ophthalmology and Optometry,Medical University Vienna,Vienna,Austria;Laboratory for Ophthalmic Image Analysis, Department of Ophthalmology,Medical University Vienna,Vienna,Austria, 2Department of Ophthalmology and Optometry,Medical University Vienna,Vienna,Austria, 3Laboratory for Ophthalmic Image Analysis, Department of Ophthalmology,Medical University Vienna,Vienna,Austria, 4Department of Ophthalmology and Optometry,Medical University Vienna,Vienna,Austria;Department of Ophthalmology,Federal University of Minas Gerais,Belo Horizonte,Brazil
Purpose
Neovascular age-related macular degeneration (nAMD) is highly prevalent in the elderly population and often occurs together with other prevalent comorbidities, such as cataract. Optical coherence tomography (OCT) is the most powerful, non-invasive imaging modality in ophthalmology. The purpose of this study is the comparison of quantitative fluid biomarkers in nAMD in six optical coherence tomography (OCT) devices to examine their quantitative differences and facilitate the implementation of automated fluid quantification to clinic and support an automated assessment of disease activity in nAMD in pre-and postoperative care.
Setting
Cross-sectional OCT comparison at the Medical University of Vienna at the Department of Ophthalmology and Optometry.
Methods
Patients with nAMD were imaged on the same day with six devices. Intraretinal fluid (IRF), Subretinal fluid (SRF) and pigment epithelial detachment (PED) volumes were quantified in nanoliters based on manual corrections of a deep-learning algorithm in each OCT: 1. Spectralis Heidelberg (SP) 2. Cirrus (CR) 3. Topcon Maestro2 (MA) 4. Topcon Triton (TR) 5. PlexElite (PE) 6. High-Resolution-Spectralis Heidelberg (HR-SP). Bland-Altman plots were created to analyse the agreement of measurements in the central 1-mm and central 6-mm between SP, CR, MA, TR, between two Swept-source OCTs (TR,PE) and between SP and HR-SP OCTs. Friedman test with post-hoc pairwise comparisons with Bonferroni correction was performed to test for significant differences.
Results
200 OCT-volumes from 50 eyes of 50 patients were included. Comparison between SP, CR, MA, TR showed a trend towards higher IRF and PED volume in SP compared to the other OCTs and no trend for SRF volume. In the central 1-mm, upper and lower limits of agreement had values between (+/-)5nl and (+/-)13nl for IRF, between (+/-)4nl and (+/-)10nl for SRF and between (+/-)13nl and (+/-)20nl for PED. IRF and SRF volumes showed no significant differences in the central 1-mm. For SRF, there were significant differences between TR-SP, TR-CR and TR-MA. PED had the highest variability in all devices with significant differences between TR-SP, TR-MA and CR-SP in the central 6-mm and TR-SP in the central 1-mm.
Conclusions
Optimization of nAMD management impacts visual outcomes in anterior segment care. Understanding the advances of quantitative fluid analyses in various OCT devices supports personalized treatment and more precise and objective assessment of disease activity in exsudative retinal disease. Consequently, artificial intelligence (AI) found its way to clinic in nAMD management. Advances in AI implementation to busy retina outpatient clinics could inspire applications of AI-based decision support to routine management of pre- and postsurgical clinical practice. Moreover, AI-based quantification of OCT biomarkers can facilitate personalized consulting before and after cataract surgery.