Influence of OSCAR-IB Criteria on Test-Retest Reliability of Cirrus HD-OCT Retinal Thickness Measurements in People With Multiple Sclerosis.

IF 7.5 1区医学 Q1 CLINICAL NEUROLOGY

Neurology® Neuroimmunology & Neuroinflammation Pub Date : 2025-11-01 Epub Date: 2025-08-29 DOI:10.1212/NXI.0000000000200458

Anna Bacchetti, Ting-Yi Lin, Brenna McCormack, Omar Ezzedin, Rozita Doosti, Gelareh Ahmadi, Nicole Pellegrini, Evan Johnson, Simidele Davis, Elle Lawrence, Gabriel Otero-Duran, Ernest Lievers, Madeline Inserra, Sooyeon Park, Devon Bonair, Anna Kim, Ananya Gulati, Kathryn C Fitzgerald, Elias S Sotirchos, Peter A Calabresi, Shiv Saidha

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Abstract

Background and objectives: Optical coherence tomography (OCT) allows evaluation of inter-eye differences (IEDs) in macular ganglion cell-inner plexiform layer (GCIPL) and peripapillary retinal nerve fiber layer (pRNFL) thicknesses to identify unilateral optic nerve involvement (UONI). UONI supports dissemination in space (DIS) as part of the 2024 revised McDonald diagnostic criteria for multiple sclerosis (MS). The OSCAR-IB quality control (QC) criteria identify suboptimal-quality OCT scans, which could potentially result in false-positive or false-negative UONI identification. We aimed to determine the influence of scans fulfilling OSCAR-IB criteria (SFO) and not fulfilling (SNFO) on test-retest reliability of pRNFL and GCIPL thicknesses/IEDs, with a commonly used OCT platform (Cirrus HD-OCT).

Methods: A total of 509 participants, including 397 people with MS, underwent Cirrus HD-OCT, with acquisition of 2 macular and optic disc scans per eye. Each scan was classified as either SFO or SNFO. There were no clinical or demographic exclusions in order to reflect a real-world clinical setting. Reproducibility was evaluated with intravisit intraclass correlation coefficients (ICCs) and coefficients of variation (COVs). IED consistency was assessed with difference-in-differences (DiDs) and probabilities of agreement (POA) for specific IED thresholds (GCIPL

Results: A total of 1,143 macular scan pairs (1,100 SFO and 42 SNFO) for GCIPL and 1,108 optic disc scan pairs (1,003 SFO and 105 SNFO) for pRNFL were analyzed. SFO demonstrated superior reliability, as compared to SNFO for GCIPL (SFO: ICC = 0.998, COV = 0.40%; SNFO: ICC 0.353, COV 10.14%) and pRNFL (SFO: ICC = 0.989, COV = 1.18%; SNFO: ICC = 0.852, COV = 3.94%) thicknesses. DiDs were lower for SFO (GCIPL 0.64 ± 0.67 μm, pRNFL: 2.00 ± 1.72 μm), as compared to SNFO (GCIPL: 10.17 ± 13.87 μm, pRNFL: 4.78 ± 5.51 μm). POA of IED thresholds (GCIPL:

Discussion: GCIPL and pRNFL thicknesses/IEDs demonstrated markedly inferior reliability in SNFO, relative to SFO. Failure to fulfill OSCAR-IB criteria influenced pRNFL measurements and, in particular, GCIPL measurements, highlighting the importance of thorough QC in the interpretation of OCT to correctly identify UONI and accurately support DIS for the diagnosis of MS.

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OSCAR-IB标准对多发性硬化症患者卷云HD-OCT视网膜厚度测量重测信度的影响

背景和目的：光学相干断层扫描（OCT）可以评估黄斑神经节细胞-内丛状层（GCIPL）和乳头周围视网膜神经纤维层（pRNFL）厚度的眼间差异（IEDs），以识别单侧视神经受累（UONI）。作为2024年修订的多发性硬化症（MS）麦克唐纳诊断标准的一部分，UONI支持空间传播（DIS）。OSCAR-IB质量控制（QC）标准确定了次优质量的OCT扫描，这可能导致假阳性或假阴性的UONI鉴定。我们的目的是利用常用的OCT平台（Cirrus HD-OCT）确定满足OSCAR-IB标准（SFO）和不满足（SNFO）的扫描对pRNFL和GCIPL厚度/IEDs的重测可靠性的影响。方法：共有509名参与者，包括397名MS患者，接受了Cirrus HD-OCT检查，每只眼睛进行2次黄斑和视盘扫描。每次扫描被分类为SFO或SNFO。为了反映真实的临床环境，没有临床或人口统计学排除。用访视类内相关系数（ICCs）和变异系数（COVs）评价重现性。结果：共分析了GCIPL的1143对黄斑扫描对（1100对SFO和42对SNFO）和pRNFL的1108对视盘扫描对（1003对SFO和105对SNFO）。SFO对GCIPL （SFO: ICC = 0.998, COV = 0.40%; SNFO: ICC 0.353, COV 10.14%）和pRNFL （SFO: ICC = 0.989, COV = 1.18%; SNFO: ICC = 0.852, COV = 3.94%）厚度的可靠性优于SNFO。SFO组（GCIPL: 0.64±0.67 μm, pRNFL: 2.00±1.72 μm）的DiDs低于SNFO组（GCIPL: 10.17±13.87 μm, pRNFL: 4.78±5.51 μm）。讨论：相对于SFO， GCIPL和pRNFL厚度/IED在SNFO中的可靠性明显较差。未能达到奥斯卡- ib标准影响了pRNFL测量，特别是GCIPL测量，强调了在OCT解释中彻底的QC对正确识别UONI和准确支持DIS诊断MS的重要性。

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来源期刊

Neurology® Neuroimmunology & Neuroinflammation Neuroscience-Neurology

CiteScore

15.60

自引率

2.30%

发文量

219

审稿时长

8 weeks

期刊介绍： Neurology Neuroimmunology & Neuroinflammation is an official journal of the American Academy of Neurology. Neurology: Neuroimmunology & Neuroinflammation will be the premier peer-reviewed journal in neuroimmunology and neuroinflammation. This journal publishes rigorously peer-reviewed open-access reports of original research and in-depth reviews of topics in neuroimmunology & neuroinflammation, affecting the full range of neurologic diseases including (but not limited to) Alzheimer's disease, Parkinson's disease, ALS, tauopathy, and stroke; multiple sclerosis and NMO; inflammatory peripheral nerve and muscle disease, Guillain-Barré and myasthenia gravis; nervous system infection; paraneoplastic syndromes, noninfectious encephalitides and other antibody-mediated disorders; and psychiatric and neurodevelopmental disorders. Clinical trials, instructive case reports, and small case series will also be featured.