Evaluation of OCT image quality in gas-filled eyes using four OCT devices

To compare optical coherence tomography (OCT) image quality obtained on postoperative day 1 under intraocular gas tamponade using four OCT devices, including two swept-source OCT (SS-OCT) and two spectral-domain OCT (SD-OCT) systems.

This retrospective study included 30 consecutive eyes of 30 patients who underwent pars plana vitrectomy with gas tamponade between June 2025 and February 2026. On postoperative day 1, OCT imaging was performed using four devices: two SS-OCT systems (DRI OCT Triton and PLEX Elite 9000) and two SD-OCT systems (RTVue XR Avanti and SPECTRALIS OCT). OCT image quality was graded using a 5-point scale by two masked graders, and the mean score was used for analysis. The primary analysis compared image quality scores among devices in 25 eyes with macular hole using the Friedman test with Bonferroni correction.

The mean patient age was 70.0 ± 8.7 years, and 13 patients (43.3%) were male. The median (interquartile range) image quality scores in macular hole cases (n = 25) were 5.0 (4.0-5.0) for Triton, 5.0 (4.0-5.0) for Plex Elite, 4.0 (4.0-5.0) for Avanti, and 2.0 (1.0-3.0) for Spectralis. Image quality scores differed significantly among the four devices (Friedman test, p < 0.001).

Under intraocular gas tamponade, the SD-OCT device Avanti demonstrated relatively preserved image quality. These findings suggest that device-specific acquisition characteristics, beyond wavelength differences, substantially influence OCT image quality in gas-filled eyes. These findings may assist clinicians in selecting appropriate OCT devices for reliable postoperative assessment under gas tamponade.