(2026) Lessons Learned: Quality Analysis of Optical Coherence Tomography in Neuromyelitis Optica. Annals of clinical and translational neurology. pp. 581-592. ISSN 2328-9503 (Electronic) 2328-9503 (Linking)
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Abstract
INTRODUCTION: Optical coherence tomography (OCT)-derived retina measurements are markers for neuroaxonal visual pathway status. High-quality OCT scans are essential for reliable measurements, but their acquisition is particularly challenging in eyes with severe visual impairment, as often observed in neuromyelitis optica spectrum disorders (NMOSD). OBJECTIVE: To investigate OCT quality issues in real-world data from the international Collaborative Retrospective Study on Retinal OCT in Neuromyelitis Optica (CROCTINO). METHODS: We evaluated the quality of peripapillary and macular OCT scans, using Heidelberg Spectralis SD-OCT, Carl Zeiss Cirrus HD-OCT, or Topcon SD-OCT across 22 centers. Experienced graders applied OSCAR-IB criteria for OCT quality. Eyes were classified as severely visually impaired or not based on a 1.0 logMAR cut-off. Quality outcomes were compared using the Chi-square test. RESULTS: A total of 3075 OCT scans (1630 peripapillary, 1445 macular) from 539 people with NMOSD and related conditions were evaluated. Macular scans were rejected more often than peripapillary scans due to quality issues (20.1 vs. 14.5, p < 0.001). Rejection rates were higher in eyes with severe visual impairment (peripapillary: 28.9, macular: 41.6) compared to eyes without severe visual impairment (peripapillary: 10.7, p < 0.001; macular: 14.6, p < 0.001). CONCLUSION: Our study revealed that approximately one in six scans was rejected due to low quality, with higher rejection rates in eyes with severe visual impairment. As scan quality can bias quantitative outcomes and artificial intelligence applications, these findings emphasize the unmet need for standardized OCT practices tailored to NMOSD and other conditions involving severe visual impairment.
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| Keywords: | Humans *Tomography, Optical Coherence/standards/methods *Neuromyelitis Optica/diagnostic imaging Adult Female Male Retrospective Studies Middle Aged Young Adult *Retina/diagnostic imaging Aged OCT scan quality OSCAR-IB criteria neuromyelitis optica spectrum disorders optic neuritis optical coherence tomography Standing Committee on Science Member for the Canadian Institutes of Health Research, and is part of a consortium funded by the U.S. Department of Defense unrelated to this study. P.V. has received consultancy fees and holds stocks in Bionure Therapeutics, Accure Therapeutics, Attune Neurosciences, Adhera Health, Clight, QMENTA, Clarity, Oculis, and NeuroPrex. H.S.-K. reports research support from Quarck, travel support, and personal fees from Quarck and Roche. Y.M.-D. has served as a consultant and/or received grant support from: Acorda, Bayer Pharmaceutical, Biogen Idec, Celgene, EMD Serono, Genzyme, Novartis, Questor, Chugai, and Teva Neuroscience and is currently supported by grants from NIH NIAID Autoimmune Center of Excellence: UM1-AI110557 NIH NINDS R01-NS080821. M.R. received speaker honoraria from Novartis, Bayer Vital GmbH, Roche, Alexion, Horizon/Amgen, and Ipsen, and travel reimbursement from Bayer Schering, Biogen Idec, Merz, Genzyme, Teva, Roche, Alexion, Horizon/Amgen, and Merck, none related to this study. J.H. reports a grant for OCT research from the Friedrich-Baur-Stiftung, Horizon, Roche, and Merck personal fees and nonfinancial support from Alexion, Amgen, Biogen, BMS, Horizon, J&J, Neuraxpharm, Novartis, Merck, Roche and nonfinancial support from the Sumaira-Foundation and Guthy-Jackson Charitable Foundation, all outside the submitted work. M.A.L.P. has received funding for travel and speaker honoraria from Novartis, Horizon Therapeutics, and Roche. H.J.K. has received a grant from the National Research Foundation of Korea and research support from AprilBio, Eisai, Good T cells, and UCB received consultancy/speaker fees from Alexion, Altos Biologics, AstraZeneca, Biogen, Daewoong Pharmaceutical, Eisai, GC Pharma, Handok Pharmaceutical, Kaigene, Kolon Life Science, MDimune, Merck, Mitsubishi Tanabe Pharma, Roche, and Sanofi is a co-editor for the Multiple Sclerosis Journal and an associate editor for the Journal of Clinical Neurology. Jacqueline Palace has received support for scientific meetings and honorariums for advisory work from Merck Serono, Novartis, Chugai, Alexion, Roche, Medimmune, Amgen, Vitaccess, UCB, Mitsubishi, Amplo, and Janssen. Grants from Alexion, Argenx, Clene, Roche, Medimmune, and Amplo biotechnology. Patent ref. P37347WO and license agreement Numares multimarker MS diagnostics. Shares in AstraZeneca. Her group has been awarded an ECTRIMS fellowship and a Sumaira Foundation grant to start later this year. A Charcot fellow worked in Oxford 2019-2021. She acknowledges partial funding to the trust by Highly Specialized Services NHS England. She is on the medical advisory boards of the Sumaira Foundation and MOG Project charities, is a member of the Guthy-Jackson Foundation Charity, and is on the Board of the European Charcot Foundation and a member of MAGNIMS and the UK NHSE IVIG Committee and chairman of the NHSE Neuroimmunology Patient Pathway and ECTRIMS Council member on the educational committee since June 2023. Currently on the ABN advisory groups for MS and neuroinflammation and recently on the neuromuscular diseases advisory group. M.I.L. is funded by the NHS (Myasthenia and Related Disorders Service and National Specialized Commissioning Group for Neuromyelitis Optica, UK) and by the University of Oxford, UK. She has been awarded research grants from UK associations for patients with myasthenia and with muscular disorders (Myaware and Muscular Dystrophy UK, respectively) and the University of Oxford. She has received speaker honoraria or travel grants from the Guthy-Jackson Charitable Foundation, argenx, and UCB. She serves on scientific or educational advisory boards for argenx, Amgen, and UCB. S.S.I. received funding for travel and speaker honoraria from Merck Serono (Thailand), Roche (Thailand), DKSH (Thailand), Pacific Healthcare (Thailand), Easai (Thailand), Biogen Idec, UCB (Thailand), and Novartis. O.A. has received honoraria for speaking/consultation and travel grants from Bayer Healthcare, Biogen Idec, Chugai, Novartis, Medimmune, Merck Serono, and Teva and research grants from Bayer Healthcare, Biogen Idec, Novartis, and Teva. P.A. received, with the approval of the Rector of Heinrich-Heine University and the CEO of University of Dusseldorf Hospital, personal fees, research grants, and non-financial support from Allergan, Biogen, Celgene, Janssen Cilag, Ipsen, Merck Serono, Merz Pharmaceuticals, Novartis, and Roche, personal fees and non-financial support from Bayer Healthcare, Teva, and Sanofi-Aventis/Genzyme, and grants from the German Research Foundation (DFG), all outside the submitted work. L.L. received honoraria for consulting services from Merck KGaA, Hoffmann-La Roche Ltd. R.M. serves on the scientific advisory board for MedImmune and has received funding for travel and honoraria from Biogen, Merck Serono, Novartis, Sanofi-Genzyme, Roche, and Teva. D.B.B. has received speaking/consulting honoraria from Bayer Health Care, Biogen Idec, Merck, Sanofi-Genzyme, TEVA, Alexion, Horizon, and Roche and had travel expenses to scientific meetings sponsored by Bayer Health Care, Merck Serono, TEVA, and Roche. I.M.T. has received speaking/consulting honoraria from Carl Zeiss Meditech, Bausch and Lomb, and Cristalia. A.A. reports personal fees from received honoraria for giving educational presentations on multiple sclerosis, NMOSD and neuroimmunology from Novartis and Alexion. Dr. Altintas has received travel and registration coverage for attending several national and international meetings from Merck-Serono. A.J. has received compensation for advisory board, consulting, meeting attendance, and speaking from Astra Zeneca Pharmaceuticals. S.H. is partly funded by NHS England Highly Specialized Services to run a NMO UK service. S.H. is funded by the NHS (National Specialized Commissioning Group for Neuromyelitis Optica, UK). He is also funded by an NIHR SCPRA grant. M.R.Y. is founder of NovaDigm Therapeutics Inc., ImmunoTx LLC, Tegos Therapeutics LLC, and Metacin Inc. He is principal inventor on U.S. and international patents regarding anti-infectives, immunotherapeutics, and vaccines. He has received research funding from the National Institutes of Health (NIH), National Institute of Allergy and Infectious Diseases (NIAID), and Department of Defense (DOD), United States of America. He has received speaker or advisory honoraria from Alexion/AstraZeneca, Horizon/Amgen, and Genentech/Roche. He serves as Chair Advisor to the Guthy-Jackson Charitable Foundation. A.U.B. is cofounder and shareholder of Motognosis GmbH and Nocturne GmbH. He is named as inventor on several patent applications regarding MS serum biomarkers, OCT image analysis and perceptive visual computing. A.U.B. is now a fulltime employee and holds stocks of Eli Lilly and Corporation. His contribution to this work is his own and does not reflect Eli Lilly and Corporation. F.P. reports research grants and speaker honoraria from Bayer, Teva, Genzyme, Merck, Novartis, MedImmune and is a member of the steering committee of the OCTIMS study (Novartis), all unrelated to this work. F.C.O. currently receives research support from the Hertie Foundation, the Deutsche Forschungsgemeinschaft (DFG), and Novartis, all unrelated to this study. She received fellowship support from the American Academy of Neurology and the National MS Society until 2023. She is a board member of the International Multiple Sclerosis Visual System (IMSVISUAL) Consortium and an editorial board member of DGNeurologie. She received speaker honoraria from UCB. H.G.Z. reports grants from Novartis, unrelated to this study. The remaining authors declare that no conflicts of interest. |
| Page Range: | pp. 581-592 |
| Journal or Publication Title: | Annals of clinical and translational neurology |
| Journal Index: | Pubmed |
| Volume: | 13 |
| Number: | 3 |
| Identification Number: | https://doi.org/10.1002/acn3.70235 |
| ISSN: | 2328-9503 (Electronic) 2328-9503 (Linking) |
| Depositing User: | خانم ناهید ضیائی |
| URI: | http://eprints.mui.ac.ir/id/eprint/34716 |
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