Radial SD-OCT scan adequate for routine clinical decisions

This retrospective study found that the high-resolution Heidelberg spectral-domain OCT (SD-OCT) six-line radial scan pattern is comparable to the 25-line raster scan in detecting various macular pathologies. As a result, the radial scan alone may be adequate for guiding day-to-day clinical decisions.

The authors compared the detection abilities of the six-line radial and the 25-line raster SD-OCT scans in 365 eyes with neovascular AMD, diabetic macular edema (DME), central or branch retinal vein occlusion (BRVO/CRVO), central serous chorioretinopathy, vitreomacular traction, or full-thickness macular hole.

The radial scan was statistically comparable to the raster scan at detecting fluid in DME, BRVO/CRVO and central serous chorioretinopathy, but not neovascular AMD. However, it was superior to the raster pattern at detecting early macular hole formation and demonstrated a positive trend for identifying focal vitreomacular traction.

These findings support the conclusion that the more time-efficient radial scan alone is sufficient to guide clinical decisions in DME, RVO and vitreoretinal interface pathology and as an adjunct in wet AMD.

However, obtaining adequate alignment with radial scan can be challenging in patients with central fixation difficulties attributable to advanced macular pathology. In such instances, in order to ensure reliable detection of pathology it is critical to work with experienced photographers adept at manually achieving absolute centralization of the radial scan over the fovea.