Korean J Ophthalmol.  2012 Feb;26(1):32-38. 10.3341/kjo.2012.26.1.32.

Retinal Nerve Fiber Layer Measurement Variability with Spectral Domain Optical Coherence Tomography

Affiliations
  • 1Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. mskook@amc.seoul.kr
  • 2Division of Biostatistics, Center for Medical Research and Information, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Abstract

PURPOSE
To evaluate the effect of the scanning laser ophthalmoscope (SLO) guided re-test mode on short- and long-term measurement variability of peripapillary retinal nerve fiber layer (RNFL) thickness obtained by spectral domain-SLO optical coherence tomography (SD-SLO/OCT).
METHODS
Seventy five healthy eyes were scanned 3 times per day (intra-session variability) by both the SLO guided re-test mode and the independent mode of SD-SLO/OCT. Subjects were scanned 3 times by both modes at visits within a 2-week interval (inter-session variability). For testing longitudinal variability, 3 separate exams were performed over 6 months by both modes. The coefficient of variation (CV), reproducibility coefficient (RC) and intraclass correlation coefficient of RNFL thickness were compared between the two modes.
RESULTS
The intra-session RC and CV ranged from 5.4 to 12.9 microns and 1.76% to 5.72% when measured by independent mode and 5.4 to 12.5 microns and 1.75% to 5.58% by re-test mode, respectively. The inter-session RC and CV ranged from 5.8 to 13.3 microns and 1.89% to 5.78% by independent mode and 5.8 to 12.7 microns and 1.90% to 5.54% by re-test mode, respectively. Intra-session and inter-session variability measurements were not significantly different between the two modes. The longitudinal RC and CV ranged from 8.5 to 19.2 microns and 2.79% to 7.08% by independent mode and 7.5 to 14.4 microns and 2.33% to 6.22% by re-test mode, respectively. Longitudinal measurement variability was significantly lower when measured by the re-test mode compared to the independent mode (average, p = 0.011).
CONCLUSIONS
The SLO guided re-test mode for RNFL thickness measurement in SD-SLO/OCT employing a tracking system improved long-term reproducibility by reducing variability induced by inconsistent scan circle placement.

Keyword

Optical coherence tomography; Reproducibility; Retinal nerve fiber layer; Tracking system

MeSH Terms

Adult
Algorithms
Anatomy, Cross-Sectional
Female
Humans
Male
Nerve Fibers
Ophthalmoscopes
Reference Values
Reproducibility of Results
Retinal Ganglion Cells/*cytology
Tomography, Optical Coherence/*methods

Reference

1. Burgansky-Eliash Z, Wollstein G, Chu T, et al. Optical coherence tomography machine learning classifiers for glaucoma detection: a preliminary study. Invest Ophthalmol Vis Sci. 2005. 46:4147–4152.
2. Leung CK, Chan WM, Yung WH, et al. Comparison of macular and peripapillary measurements for the detection of glaucoma: an optical coherence tomography study. Ophthalmology. 2005. 112:391–400.
3. Medeiros FA, Doshi R, Zangwill LM, et al. Long-term variability of GDx VCC retinal nerve fiber layer thickness measurements. J Glaucoma. 2007. 16:277–281.
4. Kanamori A, Nagai-Kusuhara A, Escano MF, et al. Comparison of confocal scanning laser ophthalmoscopy, scanning laser polarimetry and optical coherence tomography to discriminate ocular hypertension and glaucoma at an early stage. Graefes Arch Clin Exp Ophthalmol. 2006. 244:58–68.
5. Manassakorn A, Nouri-Mahdavi K, Caprioli J. Comparison of retinal nerve fiber layer thickness and optic disk algorithms with optical coherence tomography to detect glaucoma. Am J Ophthalmol. 2006. 141:105–115.
6. Naithani P, Sihota R, Sony P, et al. Evaluation of optical coherence tomography and heidelberg retinal tomography parameters in detecting early and moderate glaucoma. Invest Ophthalmol Vis Sci. 2007. 48:3138–3145.
7. Parikh RS, Parikh S, Sekhar GC, et al. Diagnostic capability of optical coherence tomography (Stratus OCT 3) in early glaucoma. Ophthalmology. 2007. 114:2238–2243.
8. Nouri-Mahdavi K, Nikkhou K, Hoffman DC, et al. Detection of early glaucoma with optical coherence tomography (Stratus OCT). J Glaucoma. 2008. 17:183–188.
9. Schuman JS, Pedut-Kloizman T, Hertzmark E, et al. Reproducibility of nerve fiber layer thickness measurements using optical coherence tomography. Ophthalmology. 1996. 103:1889–1898.
10. Blumenthal EZ, Williams JM, Weinreb RN, et al. Reproducibility of nerve fiber layer thickness measurements by use of optical coherence tomography. Ophthalmology. 2000. 107:2278–2282.
11. Paunescu LA, Schuman JS, Price LL, et al. Reproducibility of nerve fiber thickness, macular thickness, and optic nerve head measurements using Stratus OCT. Invest Ophthalmol Vis Sci. 2004. 45:1716–1724.
12. Budenz DL, Chang RT, Huang X, et al. Reproducibility of retinal nerve fiber thickness measurements using the stratus OCT in normal and glaucomatous eyes. Invest Ophthalmol Vis Sci. 2005. 46:2440–2443.
13. Gabriele ML, Ishikawa H, Wollstein G, et al. Optical coherence tomography scan circle location and mean retinal nerve fiber layer measurement variability. Invest Ophthalmol Vis Sci. 2008. 49:2315–2321.
14. Cheung CY, Leung CK, Lin D, et al. Relationship between retinal nerve fiber layer measurement and signal strength in optical coherence tomography. Ophthalmology. 2008. 115:1347–1351. 1351.e1–1351.e2.
15. Bland JM, Altman DG. Measurement error. BMJ. 1996. 312:1654.
16. Lin D, Leung CK, Weinreb RN, et al. Longitudinal evaluation of optic disc measurement variability with optical coherence tomography and confocal scanning laser ophthalmoscopy. J Glaucoma. 2009. 18:101–106.
17. Leung CK, Cheung CY, Lin D, et al. Longitudinal variability of optic disc and retinal nerve fiber layer measurements. Invest Ophthalmol Vis Sci. 2008. 49:4886–4892.
18. Stein DM, Wollstein G, Ishikawa H, et al. Effect of corneal drying on optical coherence tomography. Ophthalmology. 2006. 113:985–991.
19. Wu Z, Vazeen M, Varma R, et al. Factors associated with variability in retinal nerve fiber layer thickness measurements obtained by optical coherence tomography. Ophthalmology. 2007. 114:1505–1512.
20. Wu Z, Huang J, Dustin L, Sadda SR. Signal strength is an important determinant of accuracy of nerve fiber layer thickness measurement by optical coherence tomography. J Glaucoma. 2009. 18:213–216.
21. Cheung CY, Yiu CK, Weinreb RN, et al. Effects of scan circle displacement in optical coherence tomography retinal nerve fibre layer thickness measurement: a RNFL modelling study. Eye (Lond). 2009. 23:1436–1441.
22. Leung CK, Cheung CY, Weinreb RN, et al. Retinal nerve fiber layer imaging with spectral-domain optical coherence tomography: a variability and diagnostic performance study. Ophthalmology. 2009. 116:1257–1263. 1263.e1–1263.e2.
23. Vizzeri G, Weinreb RN, Gonzalez-Garcia AO, et al. Agreement between spectral-domain and time-domain OCT for measuring RNFL thickness. Br J Ophthalmol. 2009. 93:775–781.
24. Gonzalez-Garcia AO, Vizzeri G, Bowd C, et al. Reproducibility of RTVue retinal nerve fiber layer thickness and optic disc measurements and agreement with Stratus optical coherence tomography measurements. Am J Ophthalmol. 2009. 147:1067–1074. 1074.e1
25. Menke MN, Knecht P, Sturm V, et al. Reproducibility of nerve fiber layer thickness measurements using 3D fourier-domain OCT. Invest Ophthalmol Vis Sci. 2008. 49:5386–5391.
26. Medeiros FA, Zangwill LM, Bowd C, et al. Evaluation of retinal nerve fiber layer, optic nerve head, and macular thickness measurements for glaucoma detection using optical coherence tomography. Am J Ophthalmol. 2005. 139:44–55.
27. Artes PH, Nicolela MT, LeBlanc RP, Chauhan BC. Visual field progression in glaucoma: total versus pattern deviation analyses. Invest Ophthalmol Vis Sci. 2005. 46:4600–4606.
28. Wollstein G, Schuman JS, Price LL, et al. Optical coherence tomography longitudinal evaluation of retinal nerve fiber layer thickness in glaucoma. Arch Ophthalmol. 2005. 123:464–470.
29. Leung CK, Cheung CY, Weinreb RN, et al. Evaluation of retinal nerve fiber layer progression in glaucoma: a study on optical coherence tomography guided progression analysis. Invest Ophthalmol Vis Sci. 2010. 51:217–222.
Full Text Links
  • KJO
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr