title: Patient characteristics associated with artifacts in Spectralis optical coherence tomography imaging of the retinal nerve fiber layer in glaucoma.
abstract: OBJECTIVE
  To determine patient factors and eye conditions associated with artifacts in Spectralis optical coherence tomography (OCT) retinal nerve fiber layer (RNFL) scans.
  
  
  METHODS
  Retrospective cross-sectional study.
  
  
  METHODS
  The prevalence of 12 artifact types were described in this review of 2313 eye scans from 1188 patients who underwent a complete eye examination with Spectralis OCT scanning during the period of September 2009 to July 2013. The generalized estimating equations model was used to analyze associations between increased artifact prevalence and 10 patient characteristics, which included age, sex, race, visual acuity, refractive error, astigmatism, cataract status, glaucoma staging, visual field reliability, and glaucoma diagnosis.
  
  
  RESULTS
  A total of 1070 or 46.3% of the 2313 eye scans had at least 1 artifact. Decentration error was the most common artifact (27.8%), followed by posterior vitreous detachment artifacts (14.4%). Visual acuity of less than 20/40 (P < .0001), presence of moderate to severe cataracts (P < .0001), advanced stage of glaucoma (P < .0001), and a diagnosis of open-angle glaucoma (P = .0003) were associated with increased prevalence of artifacts.
  
  
  CONCLUSIONS
  Clinicians should first assess scans for artifacts before making therapeutic decisions based on RNFL thickness measurements.
authors.affiliation: Harvard Medical School, Boston, Massachusetts.
authors.forename: Yingna
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Harvard Medical School, Boston, Massachusetts; Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts.
authors.forename: Huseyin
authors.initials: H
authors.lastname: Simavli
authors.affiliation: Harvard Medical School, Boston, Massachusetts; Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts.
authors.forename: Christian John
authors.initials: CJ
authors.lastname: Que
authors.affiliation: Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Rizzo
authors.affiliation: Harvard Medical School, Boston, Massachusetts; Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts.
authors.forename: Edem
authors.initials: E
authors.lastname: Tsikata
authors.affiliation: Harvard Medical School, Boston, Massachusetts; Center for Clinical Investigation, Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Rie
authors.initials: R
authors.lastname: Maurer
authors.affiliation: Harvard Medical School, Boston, Massachusetts; Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts. Electronic address: Teresa_Chen@meei.harvard.edu.
authors.forename: Teresa C
authors.initials: TC
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016477:Artifacts; D003430:Cross-Sectional Studies; D005260:Female; D005901:Glaucoma / Q000175:diagnosis*; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D009412:Nerve Fibers / Q000473:pathology*; D009901:Optic Nerve Diseases / Q000175:diagnosis; D015995:Prevalence; D015203:Reproducibility of Results; D012165:Retinal Ganglion Cells / Q000473:pathology*; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D014792:Visual Acuity; D058609:Visual Field Tests; D014794:Visual Fields