Reproducibility of Retinal Thickness Measurements on Normal and Pathologic Eyes by Different Optical Coherence Tomography Instruments

doi:10.1016/j.ajo.2010.06.025

American Journal of Ophthalmology

Volume 150, Issue 6, December 2010, Pages 815-824.e1

https://doi.org/10.1016/j.ajo.2010.06.025 Get rights and content

Purpose

To compare retinal thickness measurements produced by different time-domain and spectral-domain optical coherence tomography (TD-OCT and SD-OCT) devices when imaging normal and pathologic eyes.

Design

Prospective, observational study in an academic institutional setting.

Methods

A total of 110 eyes were imaged by 6 different OCT devices: Stratus and Cirrus (Carl Zeiss Meditec Inc), Spectralis HRA+OCT (Heidelberg Engineering), RTVue-100 (Optovue Inc), SDOCT Copernicus HR (Optopol Technology S.A.), and 3D OCT-1000 (Topcon Corporation). Eyes were normal or affected by different pathologies of the retina, including exudative and nonexudative age-related macular degeneration, epiretinal membrane, cystoid macular edema, and macular hole. For each instrument we used standard analysis protocols for macular thickness evaluation. Mean retinal thickness values between the instruments in the ETDRS central circular 1000-μm-diameter areas and in the ETDRS midperipheral circular 3000-μm-diameter areas were compared.

Results

The 6 different devices produced measurements that differ in variance (Bartlett test, P = .006), and mean values (Friedman test, P < .001). Bland-Altman analysis revealed that the limits of agreement for all the comparisons were not acceptable. Regression was calculated and it was elaborated into a conversion table, despite a high standard error for both intercepts and slope conversion values.

Conclusions

This study suggests that retinal thickness measurements obtained with various OCT devices are different beyond clinical practice tolerance, according to Bland-Altman analysis. Furthermore, regression analysis reveals high standard error values. These differences appear to be primarily attributable to the analysis algorithms used to set retinal inner and outer boundaries.

Section snippets

Methods

This prospective study was performed on consecutive patients with pathologic retinal diseases and also normal retinas at the Eye Clinic, Department of Clinical Science, Luigi Sacco Hospital, University of Milan after obtaining informed written consent. All patients underwent OCT examination on the same clinic visit using 6 different OCT instruments: Stratus (Version 4.0.2; Carl Zeiss Meditec Inc), Cirrus (Version 2.0.0.54; Carl Zeiss Meditec Inc), Spectralis HRA+OCT (Version 3.1.4; Heidelberg

Results

Image analysis was performed on a total of 110 eyes (63 patients; 23 male, 40 female). The mean patient age was 65.7 (range: 20–90); the mean corrected visual acuity was 20/32 (range: 20/320–20/20). Thirty-one of the eyes (28.2%) were normal, 25 (22.7%) were affected by exudative age-related macular degeneration, 17 (15.5%) by epiretinal membrane without foveal contour alterations, 13 (11.8%) by cystoid macular edema from diabetic retinopathy, and 12 (10.9%) by nonexudative age-related macular

Discussion

In this study retinal thickness was evaluated and compared with 6 different OCT instruments on the same patients. This was done in order to attempt to simulate a standard clinical situation, not simply focusing on normal subjects or executing repetitive measurements to validate the reproducibility of that measurement.

The results suggest that the comparison between the instruments is nearly impossible, a conclusion shared by several authors looking at both normal and pathologic eyes.31, 32, 33,

Andrea Giani, MD, received his medical degree in 2003 from University of Milan, Italy, and completed his residency in 2007 at Eye Clinic, Luigi Sacco Hospital in Milan, Italy. He collaborated with IRCCS Bietti Foundation in Rome and Eye Clinic, Luigi Sacco Hospital in Milan as clinical investigator.

He joined the Massachusetts Eye and Ear Infirmary, Harvard Medical School in 2009, where he started a research fellowship. His specialty interests include age-related macular degeneration and retinal

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He joined the Massachusetts Eye and Ear Infirmary, Harvard Medical School in 2009, where he started a research fellowship. His specialty interests include age-related macular degeneration and retinal degenerations. His clinical research interests are focused on the study of optical coherence tomography clinical applications and the evaluation of other imaging techniques, such as fundus autofluorescence. His basic research interests include the evaluation of age-related macular degeneration animal models and the assessment of new drugs efficacy in retinal degenerations.

He has published several peer-reviewed papers, he is author of numerous communication in international meetings, and he is co-author of a text on optical coherence tomography. He is a member of the Italian Association of Ophthalmology, and the Association for Research in Vision and Ophthalmology.

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Original articleReproducibility of Retinal Thickness Measurements on Normal and Pathologic Eyes by Different Optical Coherence Tomography Instruments

Purpose

Design

Methods

Results

Conclusions

Section snippets

Methods

Results

Discussion

Ophthalmology

Ophthalmology

Prog Retin Eye Res

Ophthalmology

Ophthalmology

Ophthalmology

Am J Ophthalmol

Ophthalmology

Am J Ophthalmol

Ophthalmology

Optical coherence tomography

Science

In-vivo retinal imaging by optical coherence tomography

Opt Lett

Optical coherence tomography of the human retina

Arch Ophthalmol

Optical coherence tomography in the diagnosis of subclinical serous detachment of the macula secondary to a choroidal nevus

Ophthalmic Surg Lasers

Optical coherence tomography—a review of the principles and contemporary uses in retinal investigation

Eye

Reproducibility of retinal mapping using optical coherence tomography

Arch Ophthalmol

Intersession repeatability of macular thickness measurements with the Humphrey 2000 OCT

Invest Ophthalmol Vis Sci

Repeatability and reproducibility of corneal thickness measurements by optical coherence tomography

Invest Ophthalmol Vis Sci

Retinal thickness analysis for quantitative assessment of diabetic macular edema

Arch Ophthalmol

Original article
Reproducibility of Retinal Thickness Measurements on Normal and Pathologic Eyes by Different Optical Coherence Tomography Instruments