Spectral versus Time-Domain OCT in Detecting Preoperative Epiretinal Membranes that Accompany Macular Holes

Purpose To compare the sensitivities of spectral-domain optical coherence tomography (SD-OCT) versus time-domain OCT (TD-OCT) in identifying epiretinal membranes (ERM) preoperatively in patients who underwent surgery for full-thickness macular holes (FTMH). Methods This is an interventional retrospective case series of 59 eyes diagnosed with FTMHs who underwent 25-G pars plana vitrectomy with internal limiting membrane peeling between 2009 and 2015. Preoperative OCTs were obtained by SD-OCT (Spectralis, Heidelberg, Germany) or TD-OCT (Stratus, Carl Zeiss Meditec, Dublin, CA, USA). Volume scans were reviewed for ERM accompanying the FTMH. This was compared to indocyanine green-negative staining and intraoperative findings of ERM as the gold standard. Results Baseline characteristics between the SD-OCT and TD-OCT groups were comparable. Mean duration of postoperative follow-up was 41.4 weeks (±49.0). Of 59 eyes, 33 (55.9%) exhibited an ERM intraoperatively. Four ERMs (SD-OCT group) compared to 12 (TD-OCT group) were not visualized on preoperative OCT (p = 0.003). Sensitivity and specificity of SD-OCT in ERM detection was 79% and 100% compared to 14% and 91% for TD-OCT. Visual acuity improved in both arms (0.5 and 0.3 logMAR units in SD-OCT and TD-OCT, respectively (p = 0.002, 0.0002). Conclusions We found that SD-OCT was superior to TD-OCT in identifying the presence of ERM preoperatively in patients who underwent macular hole surgery. Since ERMs may decrease the chance of successful pharmacologic vitreolysis, we recommend using SD-OCT over TD-OCT in the evaluation of patients with FTMH to more accurately identify ERMs and allow more comprehensive treatment decisions (pharmacologic versus surgical).

Comparison of Fourier-Domain and Time-Domain Optical Coherence Tomography in the Measurement of Thinnest Corneal Thickness in Keratoconus

Objective. To compare fourier-domain optical coherence tomography (FD-OCT) and time-domain OCT (TD-OCT) in the determination of thinnest corneal thickness (TCT).Methods. This study included 55 keratoconus patients and 50 healthy volunteers. The RTVue-OCT (FD-OCT) and Visante-OCT (TD-OCT) were used for the measurement of the TCT. Three consecutive scans were performed. The comparison and agreement between the two modalities were analyzed by pairedt-test, the Pearson correlation, intraclass correlation coefficient (ICC), and Bland-Altman plots. intraobserver repeatability was analyzed by the intraobserver within-subject standard deviation (S(w)), coefficient of variation (CV(w)), and ICC.Results. The TCT value of normal corneas was higher by RTVue-OCT (530.4 ± 19.7 μm) than Visante-OCT (521.5 ± 18.3 μm) (p<0.001). For keratoconus eyes, the TCT was 425.0 ± 58.2 μm and 424.4 ± 55.7 μm (difference being 0.6 ± 10.2 μm,p=0.604). Strong correlation (r= 0.938∼0.985) (ICC = 0.915–0.984) was observed between the two OCTs, and each OCT exhibited excellent repeatability in determining the TCT in all subjects (ICC = 0.984–0.994).Conclusions. The values of TCT obtained from RTVue-OCT and Visante-OCT were highly correlated; however, the two values were different. Both OCT instruments exhibited good intraobserver reliability. The existence of systematic differences suggested that the two instruments cannot be used interchangeably.