title: Comparison between Widefield En Face Swept-Source OCT and Conventional Multimodal Imaging for the Detection of Reticular Pseudodrusen.
abstract: The ability to detect reticular pseudodrusen (RPD)/subretinal drusenoid deposits (SDDs) using 12×12-mm widefield en face swept-source optical coherence tomography (SS-OCT) imaging was compared with conventional multimodal imaging (color, fundus autofluorescence (FAF), and infrared reflectance [IR] imaging) in eyes with nonexudative age-related macular degeneration (AMD).
  
  
  
  Cross-sectional study.
  
  
  
  Patients with nonexudative AMD were prospectively enrolled in an SS-OCT imaging study at the Bascom Palmer Eye Institute.
  
  
  
  On the same day, all participants underwent color, FAF, and IR fundus imaging, as well as imaging with a prototype Zeiss 100 kHz SS-OCT instrument (Carl Zeiss Meditec Inc, Dublin, CA). Two masked graders assessed the presence, absence, or uncertainty of RPD/SDDs on conventional multimodal images and separately on 4 different SS-OCT en face images derived from the same volumetric dataset. The results from grading the conventional images and the SS-OCT en face images were compared.
  
  
  
  Agreement in the detection of RPD/SDDs using different imaging modalities.
  
  
  
  A total of 307 eyes (209 patients) were graded for the presence or absence of RPD/SDDs. The agreement between SS-OCT and multimodal imaging was 83%. The difference in RPD/SDD detection with either image modality was not statistically significant (P = 0.21). The sensitivity of SS-OCT in RPD/SDD detection was 83%, and when using conventional imaging, the sensitivity was 75%. When using SS-OCT imaging alone, 10% of RPD/SDD cases would be missed, and when using conventional imaging alone, 14% of RPD/SDD cases would be missed. The presence of RPD/SDD was confirmed retrospectively in 48 of 52 cases once the overall grading was unmasked and the graders reevaluated the conventional multimodal images and the widefield SS-OCT en face images.
  
  
  
  All 4 imaging modalities used together provided the best strategy for the detection of RPD/SDDs. However, when using widefield en face SS-OCT slab imaging alone, the detection of RPD/SDDs was at least as good as conventional imaging.
authors.affiliation: Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Karen B
authors.initials: KB
authors.lastname: Schaal
authors.affiliation: Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Legarreta
authors.affiliation: Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: William J
authors.initials: WJ
authors.lastname: Feuer
authors.affiliation: Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Gregori
authors.affiliation: Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Qianqian
authors.initials: Q
authors.lastname: Cheng
authors.affiliation: Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: John E
authors.initials: JE
authors.lastname: Legarreta
authors.affiliation: Research and Development, Carl Zeiss Meditec, Inc, Dublin, California.
authors.forename: Mary K
authors.initials: MK
authors.lastname: Durbin
authors.affiliation: Research and Development, Carl Zeiss Meditec, Inc, Dublin, California.
authors.forename: Paul F
authors.initials: PF
authors.lastname: Stetson
authors.affiliation: Research and Development, Carl Zeiss Meditec, Inc, Dublin, California.
authors.forename: Sophie
authors.initials: S
authors.lastname: Kubach
authors.affiliation: Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida. Electronic address: prosenfeld@miami.edu.
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Rosenfeld
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D005451:Fluorescein Angiography; D057092:Geographic Atrophy / Q000473:pathology; D006801:Humans; D008268:Macular Degeneration / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D009887:Ophthalmoscopy / Q000379:methods; D015593:Retinal Drusen / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence / Q000379:methods*