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Abstract #50361 Published in IGR 14-2

Optic Disc Imaging with Spectral-Domain Optical Coherence Tomography: Variability and Agreement Study with Heidelberg Retinal Tomograph

Yang B; Ye C; Yu M; Liu S; Lam DS; Leung CK
Ophthalmology 2012; 119: 1852-1857


OBJECTIVE: To evaluate the agreement of optic disc measurements obtained with the Cirrus high-density optical coherence tomography (HD-OCT) and the Heidelberg retina tomograph (HRT) and compare the intervisit, test-retest variability between the instruments. DESIGN: Prospective, cross-sectional study. PARTICIPANTS: Two hundred seven subjects (109 glaucoma and 98 normal subjects). METHODS: One eye from each individual was selected randomly for optic disc imaging by the Cirrus HD-OCT and the HRT. Areas of the optic disc and the cup, cup volume, vertical cup-to-disc ratio and cup-to-disc area ratio were compared between the instruments. The OCT measurements were corrected for ocular magnification using the Littman's formula. The measurement agreement was evaluated with the Bland-Altman plots. The intervisit test-retest variability was examined in 17 randomly selected glaucoma patients who underwent optic disc imaging weekly for 8 consecutive weeks. The intraclass correlation coefficients (ICC) and the reproducibility coefficients of the optic disc parameters were computed. MAIN OUTCOME MEASURES: Measurement agreement, reproducibility coefficients, and ICCs of optic disc parameters. RESULTS: The OCT measured smaller optic disc and rim areas and greater cup volume, vertical cup-to-disc ratio and cup-to-disc area ratio than the HRT did (all with P<0.001). There were proportional biases in the Bland-Altman plots between OCT and HRT optic disc measurements except for rim area and cup-to-disc area ratio. The 95% limits of agreement of rim area ranged between -0.28 and 0.88 mm(2) before, and between -0.22 and 0.92 mm(2) after correction for ocular magnification. Both OCT and HRT showed high test-retest reproducibility with ICCs ≥0.921. Although the reproducibility coefficient of OCT rim area (0.093 mm(2); 95% confidence interval [CI], 0.081-0.105 mm(2)) was significantly smaller than that of the HRT (0.186 mm(2); 95% CI, 0.163-0.210 mm(2); P = .018), there were no differences in the ICCs between the instruments. CONCLUSIONS: Optic disc assessment by spectral-domain OCT and confocal scanning laser ophthalmoscopy demonstrates poor agreement but similarly low test-retest variability. The source of their disagreement and its effects on the detection of progression require further study. FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found after the references.

Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, PR China; Joint Shantou International Eye Center of Shantou University and Chinese University of Hong Kong, PR China.

Full article

Classification:

6.9.1.1 Confocal Scanning Laser Ophthalmoscopy (Part of: 6 Clinical examination methods > 6.9 Computerized image analysis > 6.9.1 Laser scanning)
6.9.2.2 Posterior (Part of: 6 Clinical examination methods > 6.9 Computerized image analysis > 6.9.2 Optical coherence tomography)



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