Detecting Established Glaucoma Using OCT Alone: Utilizing an OCT Reading Center in a Real-World Clinical Setting

Area of Science:

• Ophthalmology
• Medical Imaging
• Glaucoma Research

Background:

• Glaucoma diagnosis relies on detecting glaucomatous optic neuropathy (GON).
• Optical coherence tomography (OCT) provides high-resolution cross-sectional images of the optic nerve head and retinal nerve fiber layer.
• An established reading center approach may enhance diagnostic accuracy.

Purpose of the Study:

• To evaluate the diagnostic performance of an optical coherence tomography (OCT)-based reading center for glaucoma (ORG) in detecting established glaucoma.
• To assess the ability of OCT imaging alone to identify glaucomatous optic neuropathy (GON).

Main Methods:

• Included 70 patients with established glaucoma and 20 healthy controls.
• Excluded 33 eyes due to poor image quality or media opacity.
• Two masked graders assessed 122 eyes (86 glaucoma, 36 controls) using OCT reports alone to determine the presence of GON.

Main Results:

• Sensitivity for detecting established glaucoma was 98.8% at the eye level and 100% at the patient level.
• Specificity for identifying healthy eyes was 100%.
• One eye with established glaucoma was missed, but the other eye of the same patient was correctly classified.

Conclusions:

• An OCT-based reading center can effectively detect established glaucoma using OCT imaging alone.
• The ORG demonstrates high sensitivity and specificity for glaucoma diagnosis.
• This systematic OCT-based approach is validated for real-world glaucoma detection.