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Retinal nerve fiber layer imaging with spectral-domain optical coherence tomography a study on diagnostic agreement with Heidelberg Retinal Tomograph.
Ophthalmology. 2010 Feb; 117(2):267-74.O

Abstract

OBJECTIVE

To evaluate and compare the diagnostic agreement and performance for glaucoma detection between a confocal scanning laser ophthalmoscope and a spectral-domain optical coherence tomograph (OCT).

DESIGN

Prospective, cross-sectional study.

PARTICIPANTS

One hundred fifty-five subjects (79 glaucoma and 76 normal subjects).

METHODS

One eye from each individual was selected randomly for optic disc and retinal nerve fiber layer (RNFL) imaging by the Heidelberg Retinal Tomograph (HRT; Heidelberg Engineering, GmbH, Dossenheim, Germany) and the Spectralis OCT (Heidelberg Engineering), respectively. Glaucoma was defined based on the presence of visual field defects with the Humphrey visual field analyzer (Carl Zeiss Meditec, Dublin, CA). The agreement of the categorical classification ("within normal limits," "borderline," and "outside normal limits") at the temporal, superotemporal, superonasal, nasal, inferonasal and inferotemporal sectors of the optic disc were evaluated (kappa statistics). The diagnostic sensitivity and specificity between optic disc and RNFL assessment were compared (McNemar's statistics). Area under the receiver operating characteristic curve (AUC) of OCT RNFL and HRT optic disc parameters were computed after adjustment of age, axial length, and optic disc area.

MAIN OUTCOME MEASURES

Agreement of categorical classification, AUC of optic disc, and RNFL parameters.

RESULTS

The agreement of categorical classification between HRT and Spectralis OCT were fair to moderate (kappa ranged between 0.30 and 0.53) except for global (kappa = 0.63) and inferotemporal (kappa = 0.68) measurements. Defining glaucoma as having "outside normal limits" in the global and/or in >or=1 of the sectoral measurements, the respective sensitivities of Spectralis OCT and HRT were 91.1% and 79.8% (P = 0.012) at a similar level of specificity (97.4% and 94.7%). The AUC of OCT global RNFL thickness (0.978) was greater than those of HRT global rim area (0.905), vertical cup-disc ratio (0.857), rim-disc area ratio (0.897), and multivariate discriminant analysis (0.880-0.925; all with P<or=0.028) after covariates adjustment.

CONCLUSIONS

The diagnostic classification provided in the HRT and Spectralis OCT analysis report may not agree. At a comparable level of specificity, Spectralis OCT RNFL measurement attained a higher sensitivity than HRT optic disc measurement.

Authors+Show Affiliations

Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, PR China.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19969364

Citation

Leung, Christopher Kai-shun, et al. "Retinal Nerve Fiber Layer Imaging With Spectral-domain Optical Coherence Tomography a Study On Diagnostic Agreement With Heidelberg Retinal Tomograph." Ophthalmology, vol. 117, no. 2, 2010, pp. 267-74.
Leung CK, Ye C, Weinreb RN, et al. Retinal nerve fiber layer imaging with spectral-domain optical coherence tomography a study on diagnostic agreement with Heidelberg Retinal Tomograph. Ophthalmology. 2010;117(2):267-74.
Leung, C. K., Ye, C., Weinreb, R. N., Cheung, C. Y., Qiu, Q., Liu, S., Xu, G., & Lam, D. S. (2010). Retinal nerve fiber layer imaging with spectral-domain optical coherence tomography a study on diagnostic agreement with Heidelberg Retinal Tomograph. Ophthalmology, 117(2), 267-74. https://doi.org/10.1016/j.ophtha.2009.06.061
Leung CK, et al. Retinal Nerve Fiber Layer Imaging With Spectral-domain Optical Coherence Tomography a Study On Diagnostic Agreement With Heidelberg Retinal Tomograph. Ophthalmology. 2010;117(2):267-74. PubMed PMID: 19969364.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Retinal nerve fiber layer imaging with spectral-domain optical coherence tomography a study on diagnostic agreement with Heidelberg Retinal Tomograph. AU - Leung,Christopher Kai-shun, AU - Ye,Cong, AU - Weinreb,Robert N, AU - Cheung,Carol Yim Lui, AU - Qiu,Quanliang, AU - Liu,Shu, AU - Xu,Guihua, AU - Lam,Dennis Shun Chiu, Y1 - 2009/12/06/ PY - 2009/03/10/received PY - 2009/06/24/revised PY - 2009/06/25/accepted PY - 2009/12/9/entrez PY - 2009/12/9/pubmed PY - 2010/2/25/medline SP - 267 EP - 74 JF - Ophthalmology JO - Ophthalmology VL - 117 IS - 2 N2 - OBJECTIVE: To evaluate and compare the diagnostic agreement and performance for glaucoma detection between a confocal scanning laser ophthalmoscope and a spectral-domain optical coherence tomograph (OCT). DESIGN: Prospective, cross-sectional study. PARTICIPANTS: One hundred fifty-five subjects (79 glaucoma and 76 normal subjects). METHODS: One eye from each individual was selected randomly for optic disc and retinal nerve fiber layer (RNFL) imaging by the Heidelberg Retinal Tomograph (HRT; Heidelberg Engineering, GmbH, Dossenheim, Germany) and the Spectralis OCT (Heidelberg Engineering), respectively. Glaucoma was defined based on the presence of visual field defects with the Humphrey visual field analyzer (Carl Zeiss Meditec, Dublin, CA). The agreement of the categorical classification ("within normal limits," "borderline," and "outside normal limits") at the temporal, superotemporal, superonasal, nasal, inferonasal and inferotemporal sectors of the optic disc were evaluated (kappa statistics). The diagnostic sensitivity and specificity between optic disc and RNFL assessment were compared (McNemar's statistics). Area under the receiver operating characteristic curve (AUC) of OCT RNFL and HRT optic disc parameters were computed after adjustment of age, axial length, and optic disc area. MAIN OUTCOME MEASURES: Agreement of categorical classification, AUC of optic disc, and RNFL parameters. RESULTS: The agreement of categorical classification between HRT and Spectralis OCT were fair to moderate (kappa ranged between 0.30 and 0.53) except for global (kappa = 0.63) and inferotemporal (kappa = 0.68) measurements. Defining glaucoma as having "outside normal limits" in the global and/or in >or=1 of the sectoral measurements, the respective sensitivities of Spectralis OCT and HRT were 91.1% and 79.8% (P = 0.012) at a similar level of specificity (97.4% and 94.7%). The AUC of OCT global RNFL thickness (0.978) was greater than those of HRT global rim area (0.905), vertical cup-disc ratio (0.857), rim-disc area ratio (0.897), and multivariate discriminant analysis (0.880-0.925; all with P<or=0.028) after covariates adjustment. CONCLUSIONS: The diagnostic classification provided in the HRT and Spectralis OCT analysis report may not agree. At a comparable level of specificity, Spectralis OCT RNFL measurement attained a higher sensitivity than HRT optic disc measurement. SN - 1549-4713 UR - https://www.unboundmedicine.com/medline/citation/19969364/Retinal_nerve_fiber_layer_imaging_with_spectral_domain_optical_coherence_tomography_a_study_on_diagnostic_agreement_with_Heidelberg_Retinal_Tomograph_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0161-6420(09)00736-2 DB - PRIME DP - Unbound Medicine ER -