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J. Ho, A. C. Sull, L. N. Vuong, Y. Chen, J. Liu, J. G. Fujimoto, J. S. Schuman, J. S. Duker; Assessment of Artifacts, Macular Thickness and Reproducibility in Pathological Eyes Across Three Spectral / Fourier and One Time Domain Optical Coherence Tomography Instruments. Invest. Ophthalmol. Vis. Sci. 2009;50(13):1079.
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© ARVO (1962-2015); The Authors (2016-present)
To report the frequency of optical coherence tomography (OCT) scan artifacts and compare macular thickness measurements, inter-scan reproducibility and inter-device agreeability across three spectral / Fourier domain (SD) OCTs (Cirrus HD-OCT, RTVue-100 and Topcon 3D-OCT 1000) and one time domain (TD) OCT (Stratus OCT).
52 patients were recruited from the New England Eye Center retina clinic between February and August 2008. Two scans were performed for each of the SD-OCT protocols: Cirrus macular cube 512x128, RTVue (E)MM5 and MM6, Topcon 3D macular and radial, in addition to one TD-OCT scan via Stratus macular thickness protocol. Scans were inspected for six types of OCT scan artifacts and analyzed. Inter-scan reproducibility and inter-device agreeability were assessed by intraclass correlation coefficients (ICCs) and Bland-Altman plots, respectively.
TD-OCT scans contained a significantly higher percentage of clinically significant improper central foveal thickness (IFT) post-manual correction (greater than or equal to 11 µm change) compared to SD-OCT scans. Cirrus HD-OCT had a significantly lower percentage of clinically significant IFT (11.1%), compared to the other SD-OCT devices (Topcon 3D: 20.4%, Topcon Radial: 29.6%, (E)MM5: 42.6%, MM6: 24.1%; p= 0.001). Two of the three SD-OCTs (Cirrus and RTVue) had central foveal subfield thicknesses significantly greater than TD-OCT (p< 0.0001). All 3 SD-OCTs demonstrated a high degree of reproducibility in the central foveal region (ICC= 0.92 to 0.97). Bland-Altman plots showed low agreeability between TD- and SD-OCT scans.
Significant differences in macular thickness exist among SD- and TD-OCTs. Higher resolution and scan speed appear to improve reproducibility of OCT scans. Although some commercial OCTs produced fewer artifacts relative to others, they were all large enough to warrant further work on improving segmentation algorithms to decrease artifacts.
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