False-positive classification and associated factors in segmented macular layers and retinal nerve fiber layer analysis: Spectralis OCT deviation map study

Abstract The rates, patterns and associated factors for false-positive classification of deviation maps by Cirrus optical coherence tomography (OCT) have been reported. However, research on OCT layer-by-layer deviation maps is lacking. We aimed to determine the rates and associated factors for false-positive classification of segmented macular layers and retinal nerve fiber layer (RNFL) deviation maps of Spectralis OCT, and to identify false-positive patterns on segmented macular layers deviation maps. 118 healthy eyes of 118 normal participants who had undergone Spectralis OCT imaging were included. False-positive classification was determined by the area and location of yellow or red color-coded regions on the deviation map. The false-positive rates on the deviation maps were the highest on the ganglion cell layer map, followed by the inner plexiform layer, retinal layer, and RNFL maps. More myopic/less hyperopic refractive error was a factor significantly associated with higher false-positive classification on the RNFL deviation map, and three false-positive patterns were found on the segmented macular layers deviation maps. Spectralis OCT deviation maps should be interpreted carefully to avoid misdiagnosis, especially for eyes with higher degrees of myopic refractive error on the RNFL map, for which purpose, recognizing the characteristic false-positive patterns would be helpful in clinical practice.