Clinical Publications

MAESTRO

When, and why, is an OCT scan too poor to correctly identify healthy eyes?

AUTHORS:

Hood DC; Sun AJ; Gebhardt T; La Bruna S; Wang Y; Lee C; Durbin M; Tsamis E

PUBLICATION:

ARVO 2026 Abstract / Conference Presentation

Study Purpose

To classify OCT report quality according to its purpose and determine the factors that make scans too poor to reliably identify healthy eyes.

Overview

Study Design

Cross-sectional reading-center study of widefield Maestro OCT reports collected at optometry sites involved in refractive care. Reports were categorized as Healthy Metric, Healthy Suitable, Pathology/Pathology Suspect, or Poor, and poor scans were further classified by dominant artifact type.

# of Eyes/
Patients

6742 eyes/individuals

Study Device

Widefield OCT using Maestro (Topcon Corporation, Tokyo, Japan)

Outcome Measures

Distribution of scan-quality categories by age, frequency of major causes of poor scans (global weak signal, clipping, eye movement/blinks, disk or fovea centering), and relationship between reading-center quality classifications and the commercial Image Quality Score (IQS).

Results

The percentage of scans graded Healthy Metric decreased with increasing age, while Healthy Suitable, Pathology/Pathology Suspect, and Poor classifications increased. Among eyes older than 80 years, only 33.5% were graded Healthy Metric, whereas 35.1% were graded Pathology/Pathology Suspect and 23.5% were graded Poor. In eyes aged 70 years and older, global weak signal accounted for 68% of poor scans, while clipping was the leading cause among adults aged 30-49 years (34%). The Image Quality Score was a poor predictor of the reading-center scan-quality grades.

IMOvifa reduced measurement time by

39%

Conclusions

Age is a major predictor of poor-quality OCT scans in community optometry settings. For older adults, especially those over 70 years, qualitative review and/or improved acquisition methods may be needed because standard metric-based assessment alone is often insufficient to reliably identify healthy eyes.