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Lessons Learned: Quality Analysis of Optical Coherence Tomography in Neuromyelitis Optica

  • Hadi Salih
  • , Sara Samadzadeh
  • , Charlotte Bereuter
  • , Seyedamirhosein Motamedi
  • , Claudia Chien
  • , Pablo Villoslada
  • , Hadas Stiebel-Kalish
  • , Nasrin Asgari
  • , Yang Mao-Draayer
  • , Marius Ringelstein
  • , Joachim Havla
  • , Marco Aurélio Lana Peixoto
  • , Ho Jin Kim
  • , Jacqueline Palace
  • , Maria Isabel Leite
  • , Srilakshmi M. Sharma
  • , Fereshteh Ashtari
  • , Rahele Kafieh
  • , Lekha Pandit
  • , Orhan Aktas
  • Philipp Albrecht, Letizia Leocani, Itay Lotan, Sasitorn Siritho, J. rôme de Seze, Romain Marignier, Caroline Froment Tilikete, Denis Bernardi Bichuetti, Ivan Maynart Tavares, Ayse Altintas, Anu Jacob, Saif Huda, Ibis Soto de Castillo, Lawrence J. Cook, Michael R. Yeaman, Axel Petzold, Alexander U. Brandt, Friedemann Paul*, with the Guthy Jackson Charitable Foundation—International Clinical Consortium and CROCTINO Collaborators
*Corresponding author for this work
  • Max Delbrück Center for Molecular Medicine in the Helmholtz Association
  • Charité – Universitätsmedizin Berlin
  • University of Southern Denmark
  • Slagelse Hospital
  • Hospital del Mar
  • Rabin Medical Center Israel
  • Tel Aviv University
  • Oklahoma Medical Research Foundation
  • Heinrich Heine University Düsseldorf
  • Ludwig Maximilian University of Munich
  • Universidade Federal de Minas Gerais
  • National Cancer Center Korea
  • Oxford University Hospitals NHS Foundation Trust
  • Isfahan University of Medical Sciences
  • Durham University
  • K.S. Hegde Medical Academy
  • Maria Hilf Clinics GmbH
  • University of California at Los Angeles
  • IRCCS San Raffaele Scientific Institute
  • Casa di Cura Igea
  • Bumrungrad Hospital
  • Les Hôpitaux Universitaires de Strasbourg
  • Hôpital neurologique et neurochirurgical Pierre Wertheimer
  • Hospices civils de Lyon
  • Universidade Federal de São Paulo
  • Koc University
  • Istanbul University
  • The Walton Centre NHS Foundation Trust
  • Cleveland Clinic Abu Dhabi
  • University of Liverpool
  • Hospital General del Sur
  • University of Utah
  • University College London
  • Berliner Institut für Gesundheitsforschung
  • Einstein Center Digital Future

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Introduction: Optical coherence tomography (OCT)-derived retina measurements are markers for neuroaxonal visual pathway status. High-quality OCT scans are essential for reliable measurements, but their acquisition is particularly challenging in eyes with severe visual impairment, as often observed in neuromyelitis optica spectrum disorders (NMOSD). Objective: To investigate OCT quality issues in real-world data from the international Collaborative Retrospective Study on Retinal OCT in Neuromyelitis Optica (CROCTINO). Methods: We evaluated the quality of peripapillary and macular OCT scans, using Heidelberg Spectralis SD-OCT, Carl Zeiss Cirrus HD-OCT, or Topcon SD-OCT across 22 centers. Experienced graders applied OSCAR-IB criteria for OCT quality. Eyes were classified as severely visually impaired or not based on a 1.0 logMAR cut-off. Quality outcomes were compared using the Chi-square test. Results: A total of 3075 OCT scans (1630 peripapillary, 1445 macular) from 539 people with NMOSD and related conditions were evaluated. Macular scans were rejected more often than peripapillary scans due to quality issues (20.1% vs. 14.5%, p < 0.001). Rejection rates were higher in eyes with severe visual impairment (peripapillary: 28.9%, macular: 41.6%) compared to eyes without severe visual impairment (peripapillary: 10.7%, p < 0.001; macular: 14.6%, p < 0.001). Conclusion: Our study revealed that approximately one in six scans was rejected due to low quality, with higher rejection rates in eyes with severe visual impairment. As scan quality can bias quantitative outcomes and artificial intelligence applications, these findings emphasize the unmet need for standardized OCT practices tailored to NMOSD and other conditions involving severe visual impairment.

Original languageEnglish
JournalAnnals of clinical and translational neurology
Early online date2025
DOIs
Publication statusE-pub ahead of print - 2025
Externally publishedYes

Keywords

  • OCT scan quality
  • OSCAR-IB criteria
  • neuromyelitis optica spectrum disorders
  • optic neuritis
  • optical coherence tomography

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