Reproducibility of retinal nerve fiber thickness measurements using the stratus OCT in normal and glaucomatous eyes

Donald L. Budenz, Robert T. Chang, XiangRun Huang, Robert W. Knighton, James M. Tielsch

Research output: Contribution to journalArticle

239 Citations (Scopus)

Abstract

PURPOSE. To determine the reproducibility of Stratus Optical Coherence Tomography (OCT) retinal nerve fiber layer (RNFL) measurements around the optic nerve in normal and glaucomatous eyes. METHODS. One eye was chosen at random from 88 normal subjects and 59 glaucomatous subjects distributed among mild, moderate, and severe glaucoma, determined by visual field testing. Subjects underwent six RNFL thickness measurements performed by a single operator over a 30-minute period with a brief rest between sessions. Three scans were taken with the high-density Standard RNFL protocol, and three were taken with the Fast RNFL protocol, alternating between scan protocols. RESULTS. Reliability, as measured by intraclass correlation coefficient (ICC), was calculated for the overall mean RNFL thickness and for each quadrant. The ICC for the mean Standard RNFL thickness (and lower 95% confidence interval [CI]) in normal and glaucomatous eyes was 0.97 (0.96 CI) and 0.98 (0.97 CI), respectively. The ICC for the mean Fast RNFL thickness in normal and glaucomatous eyes was 0.95 (0.93 CI) and 0.97 (0.95 CI), respectively. Quadrant ICCs ranged between 0.79 and 0.97, with the nasal quadrant being the least reproducible of all four quadrants, using either the Standard or Fast RNFL program. The test-retest variability ranged from 3.5 μm for the average RNFL thickness measurements in normal eyes to 13.8 μm for the nasal quadrant measurements in glaucomatous eyes, which appeared to be the most variable. CONCLUSIONS. Reproducibility of RNFL measurements using the Stratus OCT is excellent in normal and glaucomatous eyes. The nasal quadrant appears to be the most variable measurement. Standard RNFL and Fast RNFL scans are equally reproducible and yield comparable measurements. These findings have implications for the diagnosis of glaucoma and glaucomatous progression.

Original languageEnglish
Pages (from-to)2440-2443
Number of pages4
JournalInvestigative Ophthalmology and Visual Science
Volume46
Issue number7
DOIs
StatePublished - Dec 1 2005

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Optical Coherence Tomography
Nerve Fibers
Confidence Intervals
Nose
Glaucoma
Optic Nerve
Visual Fields

ASJC Scopus subject areas

  • Ophthalmology

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Reproducibility of retinal nerve fiber thickness measurements using the stratus OCT in normal and glaucomatous eyes. / Budenz, Donald L.; Chang, Robert T.; Huang, XiangRun; Knighton, Robert W.; Tielsch, James M.

In: Investigative Ophthalmology and Visual Science, Vol. 46, No. 7, 01.12.2005, p. 2440-2443.

Research output: Contribution to journalArticle

Budenz, Donald L. ; Chang, Robert T. ; Huang, XiangRun ; Knighton, Robert W. ; Tielsch, James M. / Reproducibility of retinal nerve fiber thickness measurements using the stratus OCT in normal and glaucomatous eyes. In: Investigative Ophthalmology and Visual Science. 2005 ; Vol. 46, No. 7. pp. 2440-2443.
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abstract = "PURPOSE. To determine the reproducibility of Stratus Optical Coherence Tomography (OCT) retinal nerve fiber layer (RNFL) measurements around the optic nerve in normal and glaucomatous eyes. METHODS. One eye was chosen at random from 88 normal subjects and 59 glaucomatous subjects distributed among mild, moderate, and severe glaucoma, determined by visual field testing. Subjects underwent six RNFL thickness measurements performed by a single operator over a 30-minute period with a brief rest between sessions. Three scans were taken with the high-density Standard RNFL protocol, and three were taken with the Fast RNFL protocol, alternating between scan protocols. RESULTS. Reliability, as measured by intraclass correlation coefficient (ICC), was calculated for the overall mean RNFL thickness and for each quadrant. The ICC for the mean Standard RNFL thickness (and lower 95{\%} confidence interval [CI]) in normal and glaucomatous eyes was 0.97 (0.96 CI) and 0.98 (0.97 CI), respectively. The ICC for the mean Fast RNFL thickness in normal and glaucomatous eyes was 0.95 (0.93 CI) and 0.97 (0.95 CI), respectively. Quadrant ICCs ranged between 0.79 and 0.97, with the nasal quadrant being the least reproducible of all four quadrants, using either the Standard or Fast RNFL program. The test-retest variability ranged from 3.5 μm for the average RNFL thickness measurements in normal eyes to 13.8 μm for the nasal quadrant measurements in glaucomatous eyes, which appeared to be the most variable. CONCLUSIONS. Reproducibility of RNFL measurements using the Stratus OCT is excellent in normal and glaucomatous eyes. The nasal quadrant appears to be the most variable measurement. Standard RNFL and Fast RNFL scans are equally reproducible and yield comparable measurements. These findings have implications for the diagnosis of glaucoma and glaucomatous progression.",
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T1 - Reproducibility of retinal nerve fiber thickness measurements using the stratus OCT in normal and glaucomatous eyes

AU - Budenz, Donald L.

AU - Chang, Robert T.

AU - Huang, XiangRun

AU - Knighton, Robert W.

AU - Tielsch, James M.

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N2 - PURPOSE. To determine the reproducibility of Stratus Optical Coherence Tomography (OCT) retinal nerve fiber layer (RNFL) measurements around the optic nerve in normal and glaucomatous eyes. METHODS. One eye was chosen at random from 88 normal subjects and 59 glaucomatous subjects distributed among mild, moderate, and severe glaucoma, determined by visual field testing. Subjects underwent six RNFL thickness measurements performed by a single operator over a 30-minute period with a brief rest between sessions. Three scans were taken with the high-density Standard RNFL protocol, and three were taken with the Fast RNFL protocol, alternating between scan protocols. RESULTS. Reliability, as measured by intraclass correlation coefficient (ICC), was calculated for the overall mean RNFL thickness and for each quadrant. The ICC for the mean Standard RNFL thickness (and lower 95% confidence interval [CI]) in normal and glaucomatous eyes was 0.97 (0.96 CI) and 0.98 (0.97 CI), respectively. The ICC for the mean Fast RNFL thickness in normal and glaucomatous eyes was 0.95 (0.93 CI) and 0.97 (0.95 CI), respectively. Quadrant ICCs ranged between 0.79 and 0.97, with the nasal quadrant being the least reproducible of all four quadrants, using either the Standard or Fast RNFL program. The test-retest variability ranged from 3.5 μm for the average RNFL thickness measurements in normal eyes to 13.8 μm for the nasal quadrant measurements in glaucomatous eyes, which appeared to be the most variable. CONCLUSIONS. Reproducibility of RNFL measurements using the Stratus OCT is excellent in normal and glaucomatous eyes. The nasal quadrant appears to be the most variable measurement. Standard RNFL and Fast RNFL scans are equally reproducible and yield comparable measurements. These findings have implications for the diagnosis of glaucoma and glaucomatous progression.

AB - PURPOSE. To determine the reproducibility of Stratus Optical Coherence Tomography (OCT) retinal nerve fiber layer (RNFL) measurements around the optic nerve in normal and glaucomatous eyes. METHODS. One eye was chosen at random from 88 normal subjects and 59 glaucomatous subjects distributed among mild, moderate, and severe glaucoma, determined by visual field testing. Subjects underwent six RNFL thickness measurements performed by a single operator over a 30-minute period with a brief rest between sessions. Three scans were taken with the high-density Standard RNFL protocol, and three were taken with the Fast RNFL protocol, alternating between scan protocols. RESULTS. Reliability, as measured by intraclass correlation coefficient (ICC), was calculated for the overall mean RNFL thickness and for each quadrant. The ICC for the mean Standard RNFL thickness (and lower 95% confidence interval [CI]) in normal and glaucomatous eyes was 0.97 (0.96 CI) and 0.98 (0.97 CI), respectively. The ICC for the mean Fast RNFL thickness in normal and glaucomatous eyes was 0.95 (0.93 CI) and 0.97 (0.95 CI), respectively. Quadrant ICCs ranged between 0.79 and 0.97, with the nasal quadrant being the least reproducible of all four quadrants, using either the Standard or Fast RNFL program. The test-retest variability ranged from 3.5 μm for the average RNFL thickness measurements in normal eyes to 13.8 μm for the nasal quadrant measurements in glaucomatous eyes, which appeared to be the most variable. CONCLUSIONS. Reproducibility of RNFL measurements using the Stratus OCT is excellent in normal and glaucomatous eyes. The nasal quadrant appears to be the most variable measurement. Standard RNFL and Fast RNFL scans are equally reproducible and yield comparable measurements. These findings have implications for the diagnosis of glaucoma and glaucomatous progression.

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