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Observational Study
. 2024 May 1;50(5):481-485.
doi: 10.1097/j.jcrs.0000000000001394.

Sensitivity and specificity of SS-OCT for detecting macular pathologies vs SD-OCT

Elizabeth Yeu  1 , John P Berdahl, Preeya K Gupta, Michael Patterson
Affiliations
Observational Study

Sensitivity and specificity of SS-OCT for detecting macular pathologies vs SD-OCT

Elizabeth Yeu et al. J Cataract Refract Surg. .

Abstract

Purpose: To evaluate the sensitivity and specificity of swept-source optical coherence tomography (SS-OCT) biometer compared with the gold standard spectral-domain optical coherence tomography (SD-OCT) for detecting macular pathology in patients with cataract.

Setting: Eye Centers of Tennessee, Crossville, TN.

Design: Prospective, cross-sectional, observational, examiner-masked.

Methods: The study included 132 participants aged 50 years and older, who underwent precataract surgery work-up. All participants underwent fixation check retinal scans using SS-OCT biometer (IOLMaster 700) as well as full macular scans using Cirrus SD-OCT. 3 independent masked examiners evaluated the scans if they were normal or had a suspected pathology. Different measures of diagnostic accuracy were calculated for 3 examiners.

Results: True positive rate (sensitivity) ranged from 71.1% (32/45) to 79.2% (42/53), and false negative rate was between 20.8% (11/53) and 28.9% (13/45) for the 3 examiners. True negative rate (specificity) ranged from 86.8% (59/68) to 94.1% (64/68), and false positive rate was between 5.9 (4/68) and 13.2% (9/68). The fitted receiver operating characteristic area ranged from 0.83 to 0.95.

Conclusions: Using retinal SS-OCT biometer scans as a replacement of the dedicated macular SD-OCT for screening or diagnosing macular health would not be appropriate because of its low sensitivity. SS-OCT biometer may potentially fail to identify approximately one-fourth of patients who actually have the disease. Therefore, the final decision on macular health should be based on the gold standard SD-OCT scans. When full macular SD-OCT scans are not accessible, the limited retinal scan information from SS-OCT biometer may still provide useful insights into the macular health.

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Figures

Figure 1.
Figure 1.
The ROC curves of the SS-OCT biometer scans for discriminating eyes with healthy and pathological macula: (a) examiner 1, (b) examiner 2, and (c) examiner 3. ROC = receiver operating characteristic
See this image and copyright information in PMC

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