State Key Laboratory of Ophthalmology, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China.
Centre for Public Health, Queen's University Belfast Centre for Public Health, Belfast, UK.
Br J Ophthalmol. 2024 Jul 23;108(8):1154-1160. doi: 10.1136/bjo-2023-324012.
To evaluate the feasibility and accuracy of a portable, self-imaging optical coherence tomography (OCT) for measuring central subfield thickness (CST) and achieving diagnostic concordance for retinal lesions compared with clinic-based spectral-domain OCT (SD-OCT).
This comparative, cross-sectional study was conducted between August 2020 and February 2021. Two groups of adult participants were recruited: (1) a selected cohort of 160 participants with confirmed diagnosis and (2) a consecutive cohort of 315 participants recruited randomly. All participants underwent self-imaging OCT examination, as well as standard OCT examination. CST was automatically calculated for comparisons between the two OCT devices. Diagnostic concordance for retinal lesions and the success rate of self-imaging were assessed within the consecutive cohort.
In the selected cohort, self-imaging OCT images yielded consistent CST with SD-OCT, with a mean difference of 0.1±7.7 µm for normal eyes, 4.9±10.6 µm for macular oedema, -1.3±9.5 µm for choroidal neovascularisation, 5.0±7.8 µm for epiretinal membrane. The self-imaging OCT also demonstrated good repeatability, with a mean test-retest difference in CST of 0.7±3.9 µm and limits of agreement ranging from -6.9 to 8.3 µm. Additionally, within the consecutive cohort, interdevice κ values ranged for detecting various retinal lesions ranged from 0.8 to 1.0, except in the cases of retinal detachment (κ=0.5). All eyes (100%) in the selected cohort and 242 eyes (76.8%) in the consecutive cohort successfully completed self-imaging. Participants spent less time on self-imaging compared with SD-OCT operated by a technician (66.7±20.1 vs 73.3±32.5, p<0.01). A majority of participants (90%) found the self-imaging process 'easy' and 'comfortable'.
This study demonstrates that our self-imaging OCT and clinical-used SD-OCT are highly consistent not only in measuring the CST but also in identifying most retinal lesions.
评估便携式自成像光学相干断层扫描（OCT）在测量中央视网膜神经纤维层（CST）方面的可行性和准确性，并与基于临床的谱域 OCT（SD-OCT）相比，评估其在视网膜病变诊断方面的一致性。
本研究为 2020 年 8 月至 2021 年 2 月期间进行的一项比较性、横断面研究。招募了两组成年参与者：（1）一组有确诊诊断的 160 名选定队列参与者，以及（2）一组随机招募的 315 名连续队列参与者。所有参与者均接受了自成像 OCT 检查和标准 OCT 检查。自动计算 CST 以比较两种 OCT 设备。在连续队列中评估视网膜病变的诊断一致性和自成像的成功率。
在选定队列中，自成像 OCT 图像与 SD-OCT 产生的 CST 结果一致，正常眼的平均差异为 0.1±7.7 μm，黄斑水肿为 4.9±10.6 μm，脉络膜新生血管为-1.3±9.5 μm，视网膜内界膜为 5.0±7.8 μm。自成像 OCT 还具有良好的可重复性，CST 的平均测试-重复差异为 0.7±3.9 μm，一致性界限范围为-6.9 至 8.3 μm。此外，在连续队列中，用于检测各种视网膜病变的两种 OCT 设备之间的κ 值范围为 0.8 至 1.0，除视网膜脱离（κ=0.5）外。选定队列中的所有眼睛（100%）和连续队列中的 242 只眼睛（76.8%）均成功完成了自成像。与由技术人员操作的 SD-OCT 相比，参与者进行自成像的时间更短（66.7±20.1 秒与 73.3±32.5 秒，p<0.01）。大多数参与者（90%）认为自成像过程“简单”和“舒适”。
本研究表明，我们的自成像 OCT 与临床使用的 SD-OCT 不仅在测量 CST 方面高度一致，而且在识别大多数视网膜病变方面也高度一致。
