OCT reading centers may reduce unnecessary glaucoma specialist referrals
Interpretation of OCT images by an OCT reading center may successfully reduce the number of unnecessary glaucoma specialist referrals while also maintaining a high level of quality comparable with other screening strategies.
“Even with our traditional methods, there is important information to be garnered from the OCT alone or in conjunction with other modalities. That needs to be evaluated carefully, perhaps by way of an OCT center or even through well-designed AI technology,” Rithambara Ramachandran, MD, said at the virtual American Glaucoma Society annual meeting.
Ramachandran and colleagues evaluated glaucoma referrals from an OCT specialist based on OCT reports from three glaucoma specialists.
The community-based real-time screen study included 344 eyes. The glaucoma specialists used visual acuity, commercial OCT imaging, gonioscopy, IOP, frequency doubling testing and funduscopic assessment to determine if a glaucoma referral was needed. An OCT specialist judged the same eyes using only OCT reports to determine referrals.
The overall agreement for referral decisions among the glaucoma specialists was 60%, with 18.6% of eyes being referred by all three specialists, 16.9% being referred by two specialists, 23% being referred by one specialist and 41.6% having no glaucoma referral.
The overall referral agreement between a consensus of the glaucoma specialists (two out of three) and the OCT specialist was 74%, Ramachandran said.
However, when the OCT specialist’s report was provided to the glaucoma specialists, the overall agreement between the consensus of glaucoma specialists and the OCT report specialist rose to 85%, she said.
The results suggest that OCT specialist interpretation of OCT imaging may influence glaucoma referral patterns while providing a high-level of quality comparable with other modalities, Ramachandran said.
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Ramachandran R. A comparison of glaucoma referrals by an OCT and glaucoma specialist in a large community-based screening study. Presented at: American Glaucoma Society annual meeting; March 4-7, 2021 (virtual meeting).
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