Swept source optical coherence tomography artifacts in glaucoma patients

Purpose To demonstrate the frequency and the type of swept-source optical coherence tomography (SS –OCT) imaging artifacts in patients being evaluated glaucoma and to present common artifacts examples Methods The SS–OCT images of 101 glaucoma suspect and glaucoma patients were used to evaluate image artifacts. We used a 3 dimensional imaging data set of 6x6mm raster scan centered on the optic disc (3D disc scan) and a 3 dimensional imaging data set of 12 mm horizontal line scan centered between optic disc and the fovea (3D side scan). For each scan, both printout report and the source image of printout report were examined. Results In 101 patients, 101 3D disc scans and 97 3D wide scans were obtained. In 3D disc scan, there were 30 artifacts in source image and 23 artifacts in final report. In 3D wide scan, there were 24 artifacts in source image and 20 artifacts in final report. The most common type of artifacts for 3D disc scan source data was boundary misidentification (66.7%). That was also the most common type of artifacts of 3D wide scan source data. Ocular pathology accounted for 25% of the cause in 3D disc scan source data with artifacts and 38.9% in 3D wide disc scan source data with artifacts. Epiretinal membrane (ERM) was the most common cause of ocular pathologic artifacts Conclusion The artifacts in SS OCT images can be made by ocular pathology or software error. Operator also can be the cause of SS OCT artifact. Those factors can make errors in interpreting OCT result. Although it is known that SS OCT has an advantage in image detection efficiency, we should consider possibility of artifacts in source data and final report. Especially, we should pay attention in patient who has ocular lesions such as ERM or vitreous traction.