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Optical coherence tomography errors in glaucoma: preanalytical errors.

We thank Professor Wiwanitkit for his interest in our paper. We agree with him that preanalytical errors can and should be controlled before optical coherence tomography scan acquisition. As mentioned in our paper, some examples include proper centering of the peripapillary circle as well as proper foveal centering by the operator before scanning. However, despite the best efforts at centering by the operator, artifacts may be induced due to the microsaccades occurring during scan acquisition. Thus, eye tracking might be useful during scan acquisition. Frequent blinking can be encouraged to reduce the impact of dry eye just before scan acquisition. However, though scan errors can be reduced, they cannot be avoided altogether. This is because typical scan acquisition takes place after the pupils have been dilated and intraocular pressure has been checked, both of which require instillation of eye drops that may predispose to disturbance of the tear film. Reduction of preanalytical errors can be achieved by performing scans during a separate visit when visual field testing and gonioscopy have not been performed, both of which might contribute to corneal dryness thus affecting scan quality. This, however, may not be practical in some patients. Attention to the above two issues in addition to ensuring good dilation of the pupil should help reduce preanalytical errors.