Use of Optical Coherence Tomography by Nonexpert Personnel as a Screening Approach for Glaucoma.
Liu Melissa M, Cho Chris, Jefferys Joan L, Quigley Harry A, Scott Adrienne W
AI Summary
Non-experts successfully used OCT for glaucoma screening; cup-to-disc ratio and inferior RNFL thickness showed robust diagnostic value, suggesting potential for community screening.
Abstract
Purpose
This pilot study was conducted to assess optical coherence tomography (OCT) as a screening tool for glaucoma when used by nonexpert personnel.
Methods
This prospective case-control study included 54 patients with open-angle glaucoma and 54 age-matched comparison individuals. Optovue iVue SD-OCT imaging was performed by nonprofessional photographers on undilated patients. The sensitivity, specificity, negative predictive value, and positive predictive value of iVue scan parameters for detecting open-angle glaucoma were evaluated.
Results
The iVue cup to disc vertical ratio had a sensitivity of 0.96 [95% confidence interval (CI), 0.90-1.00] at 90% specificity and was strongly correlated with both the Cirrus HD-OCT cup to disc vertical ratio (Pearson coefficient=0.84) and the cup to disc ratio observed on dilated clinical examination by faculty ophthalmologists (Pearson coefficient=0.80). The retinal nerve fiber layer (RNFL) parameters performed robustly, but the ganglion cell complex parameters showed limited diagnostic value. The inferior quadrant thickness was among the best performing RNFL parameters, with a sensitivity of 0.87 (95% CI, 0.78-0.96) and a specificity of 0.88 (95% CI, 0.80-0.97) using the iVue normative database thresholds for abnormality.
Conclusions
OCT imaging may be performed by nonprofessional photographers on undilated patients, and quantitative parameters derived from the resultant images, particularly the vertical cup to disc ratio and the RNFL inferior quadrant thickness, demonstrate sensitivities and specificities that may be adequately robust for glaucoma screening in the community setting.
MeSH Terms
Shields Classification
Key Concepts6
The iVue cup to disc vertical ratio, when performed by nonprofessional photographers on undilated patients, had a sensitivity of 0.96 (95% confidence interval, 0.90-1.00) at 90% specificity for detecting open-angle glaucoma.
The iVue cup to disc vertical ratio was strongly correlated with both the Cirrus HD-OCT cup to disc vertical ratio (Pearson coefficient=0.84) and the cup to disc ratio observed on dilated clinical examination by faculty ophthalmologists (Pearson coefficient=0.80) in a prospective case-control study of 54 open-angle glaucoma patients and 54 age-matched controls.
The retinal nerve fiber layer (RNFL) parameters performed robustly for detecting open-angle glaucoma when using Optovue iVue SD-OCT imaging performed by nonprofessional photographers on undilated patients.
The inferior quadrant thickness, an RNFL parameter from Optovue iVue SD-OCT imaging, demonstrated a sensitivity of 0.87 (95% CI, 0.78-0.96) and a specificity of 0.88 (95% CI, 0.80-0.97) for detecting open-angle glaucoma using the iVue normative database thresholds for abnormality, when performed by nonprofessional photographers on undilated patients.
The ganglion cell complex parameters showed limited diagnostic value for detecting open-angle glaucoma when using Optovue iVue SD-OCT imaging performed by nonprofessional photographers on undilated patients.
Optical coherence tomography (OCT) imaging may be performed by nonprofessional photographers on undilated patients for glaucoma screening.
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