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Original Investigation |

Predicted and Measured Retinal Nerve Fiber Layer Thickness From Time-Domain Optical Coherence Tomography Compared With Spectral-Domain Optical Coherence Tomography

Wolfgang A. Schrems, MD1; Laura M. Schrems-Hoesl, MD1; Delia Bendschneider, MD1; Christian Y. Mardin, MD1; Robert Laemmer, MD1; Friedrich E. Kruse, MD1; Folkert K. Horn, PhD1
[+] Author Affiliations
1Department of Ophthalmology, University of Erlangen–Nuremberg, Erlangen, Germany
JAMA Ophthalmol. 2015;133(10):1135-1143. doi:10.1001/jamaophthalmol.2015.2427.
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Importance  New methods are needed to compare peripapillary retinal nerve fiber layer thickness (pRNFLT) measurements taken from time-domain optical coherence tomography (TD-OCT) and spectral-domain OCT (SD-OCT).

Objective  To compare the agreement of measured and predicted pRNFLT using different equations based on pRNFLT measurements obtained by TD-OCT and SD-OCT.

Design, Setting, and Participants  Cross-sectional single-center study that took place at the Department of Ophthalmology, University of Erlangen–Nuremberg from November 16, 2005, to June 3, 2015, and included 138 eyes of control participants, 126 eyes of patients with ocular hypertension, 128 eyes of patients with preperimetric glaucoma, and 160 eyes of patients with perimetric glaucoma. All participants had standard clinical examinations to obtain TD-OCT (via Stratus OCT) and SD-OCT (via Spectralis OCT) measurements of pRNFLT. Two groups were matched for diagnostic subgroup, eye side, sex, and age. The TD-OCT measurements of the first group were used to predict the mean SD-OCT and 6-sector vertical-split pRNFLT measurements of the second group and vice versa. The agreement between the predicted pRNFLT calculations of conversion equations and measured pRNFLT of the second group was evaluated by intraclass correlation coefficients and Bland-Altman plots.

Main Outcomes and Measures  Mean and sectoral pRNFLT measurements obtained by TD-OCT and SD-OCT as well as the agreement between measured and predicted pRNFLT.

Results  The agreement for all investigated equations to predict mean pRNFLT measurements with intraclass correlation coeffecients ranged from 0.937 to 0.939. Bland-Altman plots demonstrated systemic biases between −0.7 μm and +1.1 μm for measured and predicted mean pRNFLT measurements. The ratio method demonstrated an intraclass correlation coefficient of 0.969 for the temporal-inferior sector. The best color-code agreement between both OCT devices was achieved by the no conversion method, with κ = 0.731 (95% CI, 0.656-0.806) for the mean pRNFLT.

Conclusions and Relevance  These data suggest that the prediction of mean pRNFLT values by equations derived from TD-OCT and SD-OCT can be conducted with high levels of agreement. In individual cases and singular sectors, high prediction errors may occur. When longitudinal imaging data from both TD-OCT and SD-OCT are available, conversion equations may provide longitudinal comparability.

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Figure 1.
Difference of Stratus Optical Coherence Tomography (OCT) and Spectralis OCT Mean Retinal Nerve Fiber Layer Thickness (RFNLT)

Mean difference RNFLT measurements between Stratus OCT and Spectralis OCT, with 95% CI RFNLT for each diagnostic group (A) and the equation and test groups (B). Error bars indicate 95% CIs.

aSignificant difference of P < .05.

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Figure 2.
Bland-Altman Plots Assess the Agreement Between Predicted and Measured Mean Retinal Nerve Fiber Layer Thickness (RNFLT)

The difference between predicted and measured Stratus OCT (A-D) and Spectralis OCT (E-H) RNFLT in control participants, patients with ocular hypertension, patients with preperimetric glaucoma, and patients with perimetric glaucoma.

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Figure 3.
Influence of Glaucoma Stage on the Intraclass Correlation Coefficient (ICC)

Spectralis optical coherence tomography (OCT) and Stratus OCT unconverted peripapillary retinal nerve fiber layer thickness measurements were evaluated in 32 peripapillary sectors, demonstrating significantly lower ICCs in 2 nasoinferior sectors for patients with preperimetric glaucoma and patients with perimetric glaucoma compared with control participants. Error bars indicate 95% CIs.

aSignificantly lower intraclass correlation coefficient (P < .05).

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