Remote Widefield OCT-A Imaging Has Potential Beyond Pandemic

Soon, when a primary care provider in a remote region, or emergency department physician needs ocular imaging by an ophthalmic technician, they may be able to simply make a quick call to the tech and turn on a secure, internet-connected tablet next to the dedicated optical coherence tomography angiography (OCT-A) workstation.

During the COVID-19 pandemic, the Harvard Retinal Imaging Laboratory in Boston, MA needed to temporarily stop all study participant recruitment to better meet guidelines from the Centers for Disease Control and Prevention (CDC). Researchers in Boston who did not want to pause their ongoing work with widefield swept-source OCT-A (WF SS-OCT-A), developed and tested a novel remote imaging technique, according to an observational analysis published in Clinical Ophthalmology. The trial took place at Massachusetts Eye and Ear Infirmary (MEEI) in August and September 2020.

Four patients, 32 to 69 years of age with ocular histories including prior retinal detachment surgery, age-related macular degeneration, or retinal vein occlusion were recruited for the trial. Imaging with WF SS-OCT-A took place after participants’ regular dilated clinic examination. They were walked to the testing room by an on-site research assistant, and introduced to the setup before the assistant left the room. The patient then communicated with a remotely-based trained research fellow in a video conference call using an encrypted tablet computer. The researcher — working from an institutionally-approved desktop — provided instructions such as head position, chin placement, blink timing, and where to fix gaze; while managing the autofocus control, fundus viewport, optimization adjustments, as well as the acquire screen. Encouragement and feedback were offered.

The test was conducted using an imaging device that features an automatic quality scoring program to grade scans. The quality protocol for the investigation was a minimum score of 7/10 — all scans exceeded this mark, with a median score of 9/10 and mean signal strength of 9.25. Scans lasted from 7.2 seconds to 58 seconds, with the median time of 13.2 seconds, and mean time 19.7 seconds.

Limitations of this analysis included its small sample size and the fact that only a single imaging instrument was tested.

Reference

Garg I, Katz R, Lu Y, Miller JB. Remote imaging capture with widefield swept-source OCT angiography auring the COVID-19 pandemic. Clin Ophthal. 2022;16:477-486. doi:10.2147/OPTH.S352503

Reference

Want to read more?