Comparison of Clinically Relevant Findings from High-Speed Fourier-Domain and Conventional Time-Domain Optical Coherence Tomography

Purpose

To compare the sensitivities of high-speed Fourier-domain optical coherence tomography (FD-OCT) and conventional time-domain (TD) OCT for the detection of clinical findings important in the management of common vitreoretinal disorders.

Design

Prospective, observational study.

Methods

FD-OCT scans (128 B scans × 512 A scans) were obtained using a prototype instrument (3 D-OCT; Topcon, Tokyo, Japan) in 50 eyes of 28 consecutive patients undergoing conventional high-resolution (6 B scans × 512 A scans) TD-OCT imaging (Stratus OCT; Carl Zeiss Meditec, Dublin, California, USA). Each image set was reviewed independently for the presence of clinical findings of interest, and device sensitivities were calculated.

Results

The average sensitivity for detection of all features in this study was 94% for FD-OCT and 60% for TD-OCT. Clinical findings were identical between devices in 18% (9/50) of cases. FD-OCT detected features that were not visible on conventional OCT scans in 78% (39/50) of cases. FD-OCT was more sensitive than TD-OCT for the detection of multiple findings, including diffuse intraretinal edema (87% vs 60.9%), subretinal fluid (100% vs 46.2%), large pigment epithelium detachments (100% vs 81%), and subretinal tissue (100% vs 61.5%).

Conclusions

FD-OCT seems to be superior to TD-OCT for the detection of many clinically relevant features of vitreoretinal disease. The greater sensitivity of FD-OCT systems for the detection of intraretinal and subretinal fluid may be of particular importance for the treatment of patients with neovascular age-related macular edema. FD-OCT is likely to supplant TD-OCT as the standard of care for retinal specialists in the near future.