Enhanced Detection of Glaucoma Progression Using Widefield Swept-Source OCT.

Area of Science:

• Ophthalmology
• Medical Imaging
• Glaucoma Research

Background:

• Glaucoma diagnosis and progression monitoring rely on structural measurements.
• Conventional methods like circumpapillary retinal nerve fiber layer thickness (cpRNFLT) have limitations in detecting subtle changes.
• Widefield swept-source OCT offers a broader view of the retina.

Purpose of the Study:

• To compare the effectiveness of widefield swept-source OCT scans versus cpRNFLT measurements for detecting glaucoma progression.
• To assess the potential of widefield OCT in improving glaucoma diagnostic accuracy and trial efficiency.

Main Methods:

• A longitudinal study involving 156 eyes from 115 glaucoma participants.
• Acquisition of circumpapillary circle scans (spectral-domain OCT) and widefield 15x15 mm OCT volume scans.
• Two graders qualitatively assessed widefield OCT scans for ganglion cell complex (GCC) thickness changes over 12 months, masked to time intervals.

Main Results:

• Widefield OCT identified over twice as many progressing eyes (36.7-38.1%) compared to cpRNFLT (16.8%) at 95% specificity.
• In eyes with mean deviation (MD) ≥-6 dB, widefield OCT detected ≥3 times more progression (41.1-46.3%) than cpRNFLT (13.7%).
• Widefield OCT imaging reduced sample size requirements for clinical trials by 69-80%.

Conclusions:

• Qualitative evaluation of widefield OCT scans demonstrates superior detection rates for structural glaucoma progression compared to cpRNFLT.
• Widefield OCT represents a more sensitive tool for monitoring glaucoma and enhancing clinical trial design.