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Evaluation of a self-imaging OCT for remote diagnosis and monitoring of retinal diseases
  1. Zitian Liu1,
  2. Wenyong Huang1,
  3. Zhenyu Wang1,
  4. Ling Jin1,
  5. Nathan Congdon1,2,
  6. Yingfeng Zheng1,
  7. Shida Chen1,
  8. Yizhi Liu1
  1. 1State Key Laboratory of Ophthalmology, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
  2. 2Centre for Public Health, Queen's University Belfast Centre for Public Health, Belfast, UK
  1. Correspondence to Professor Yizhi Liu, State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, Guangdong 510060, China; liuyizhi{at}; Dr Shida Chen; chensd3{at}


Objectives To evaluate the feasibility and accuracy of a portable, self-imaging optical coherence tomography (OCT) for measuring central subfield thickness (CST) and achieving diagnostic concordance for retinal lesions compared with clinic-based spectral-domain OCT (SD-OCT).

Methods This comparative, cross-sectional study was conducted between August 2020 and February 2021. Two groups of adult participants were recruited: (1) a selected cohort of 160 participants with confirmed diagnosis and (2) a consecutive cohort of 315 participants recruited randomly. All participants underwent self-imaging OCT examination, as well as standard OCT examination. CST was automatically calculated for comparisons between the two OCT devices. Diagnostic concordance for retinal lesions and the success rate of self-imaging were assessed within the consecutive cohort.

Results In the selected cohort, self-imaging OCT images yielded consistent CST with SD-OCT, with a mean difference of 0.1±7.7 µm for normal eyes, 4.9±10.6 µm for macular oedema, −1.3±9.5 µm for choroidal neovascularisation, 5.0±7.8 µm for epiretinal membrane. The self-imaging OCT also demonstrated good repeatability, with a mean test–retest difference in CST of 0.7±3.9 µm and limits of agreement ranging from −6.9 to 8.3 µm. Additionally, within the consecutive cohort, interdevice κ values ranged for detecting various retinal lesions ranged from 0.8 to 1.0, except in the cases of retinal detachment (κ=0.5). All eyes (100%) in the selected cohort and 242 eyes (76.8%) in the consecutive cohort successfully completed self-imaging. Participants spent less time on self-imaging compared with SD-OCT operated by a technician (66.7±20.1 vs 73.3±32.5, p<0.01). A majority of participants (90%) found the self-imaging process ‘easy’ and ‘comfortable’.

Conclusions and relevance This study demonstrates that our self-imaging OCT and clinical-used SD-OCT are highly consistent not only in measuring the CST but also in identifying most retinal lesions.

  • Retina
  • Telemedicine
  • Diagnostic tests/Investigation
  • Imaging

Data availability statement

Data are available on reasonable request. Data are available on reasonable request. Deidentified participant data can be requested from the co-corresponding authors.

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Data availability statement

Data are available on reasonable request. Data are available on reasonable request. Deidentified participant data can be requested from the co-corresponding authors.

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  • Contributors Liu Y is guarantor. Concept and design: Liu Y, Zheng Y and Chen S. Full assess to all data: Liu Y, Liu Z and Chen S. Acquisition, analysis or interpretation of data: All authors, Liang Xiaoling, Yu shanshan, and the site staff. Drafting of the manuscript: Liu Z, Chen S and Zheng Y. Critical revision of the manuscript: All authors. Statistical analysis: Liu Z, Chen S, Jin L and Wang Z. Administrative, technical or material support: Huang W and Congdon N. Obtained funding: Liu Y and Liu Z. Supervision: Liu Y and Zheng Y.

  • Funding This study was supported by the Construction Project of High-Level Hospitals in Guangdong Province (303020107; 303020108; 303010303058), the National Natural Science Foundation of China (NSFC grant 82171034), Natural Science Foundation of Guangdong Province (2020A1515011282), China Postdoctoral Science Foundation (2022M723637).

  • Competing interests Liu Y and Zheng Y reported that they hold patents on the self-imaging device used in this study, and on the automated imaging analysis system associated with the imaging software used in this study. No other disclosures were reported.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.