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Determining Optic Nerve Cupping Using Optical Coherence Tomography (OCT) Versus a New Electronic Mobile Device

Sarmento, Andrea G.L., MD*; Sarmento, Adriano, PhD; Souza, Luiz L., BSc; Oliveira, Luiz A., BSc; Rios, Marcus F.R., BSc; Domingues, Thiago A.L., BSc; Paula, Jayter S., PhD; Lira, Rodrigo P.C., PhD*

doi: 10.1097/IJG.0000000000001139
Original Studies

Purpose: We present a new device that may aid in glaucoma screening. The vertical cup-to-disc ratio (CDR) obtained from a new electronic mobile device (EMD) was compared with that obtained from a spectral-domain optical coherence tomography. In addition, results from examiner’s evaluations were compared with the results mentioned above.

Methods: A single-masked study was performed to evaluate the CDR results from 110 eyes from 110 subjects whose ages ranged between 18 and 60 years (39±13 y old), of whom 66 (60%) were female individuals. Vertical CDR was analyzed 5 times with each device in a single visit and evaluated by 3 different ophthalmologists. The Spearman correlation test and Bland-Altman analysis were used to evaluate the correlation and agreement between methods.

Results: The CDR average using spectral-domain optical coherence tomography was 0.47±0.04, whereas the CDR average using EMD was 0.42±0.02. The clinical evaluation resulted in an average of 0.34±0.27. The Spearman test showed a strong correlation between vertical CDR obtained with both devices (r=0.8319; P<0.0001) and between EMD and the examiners (r=0.7156; P>0.001). Bland-Altman analysis showed good agreement between both devices as well as between EMD and the examiners (95% limits of agreement from −0.20 to 0.10 and from −0.15 to 0.30, respectively).

Conclusions: We present a low-cost, reliable EMD that may serve as an alternative to subjectively measuring vertical CDR in face-to-face consultations and hence increase the general public’s access to glaucoma screening. This may be especially useful for patients who live in remote areas.

*Federal University of Pernambuco

Informatics Center, Federal University of Pernambuco, Recife

Department of Ophthalmology, Ribeirao Preto Medical School, University of São Paulo, Ribeirao Preto

Disclosure: The authors declare no conflict of interest.

Reprints: Andrea G.L. Sarmento, MD, Rua Conego Romeu, 161 Apt 2902, Boa Viagem, Recife/PE 51.030-340, Brazil (e-mail:

Received August 10, 2018

Accepted November 14, 2018

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