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Robert Kinast, Ruojin Ren, Helen Koenigsman, Hongli Yang, Stuart Gardiner, Juan Reynaud, Steven Mansberger, Brad Fortune, Shaban Demirel, Claude Burgoyne; Glaucoma Clinician (GC) Color Stereophoto (CSphoto) Rim Estimation Compared to Colocalized Spectral Domain Optical Coherence Tomography (SDOCT) Minimum Rim Measurements. Invest. Ophthalmol. Vis. Sci. 2013;54(15):4827. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To compare GC CSphoto neuroretinal rim width (RWGC) and area (RAGC) to colocalized SDOCT minimum rim width (MRWSDOCT) and area (MRASDOCT) in 53 eyes of 53 glaucoma and glaucoma suspect patients.
For each eye, same day CSphotos and SDOCT data sets (Spectralis, Heidelberg Engineering) were colocalized using the SDOCT IR image. Bruch’s membrane opening (BMO) and the internal limiting membrane (ILM) were hand delineated within the SDOCT data sets and MRWSDOCT/MRASDOCT were calculated based on the minimum distance between BMO and the ILM within 12 sectors based on the fovea - BMOcentroid (FoBMO) axis (Figure 1). Five GCs independently delineated the disc (DM) and rim margin (RM) within the colocalized CSphotos generating RWGC and RAGC estimates within the same FoBMO sectors. For each sector of each eye, the magnitude of each GC RW and RA estimate as well as their difference from MRWSDOCT and MRASDOCT were recorded. Generalized estimating equations were used to assess the significance of GC versus SDOCT differences accounting for inter-clinician correlations for the same eye.
Between GC differences in mean RWGC and mean RAGC (Figure 1) were substantial. While mean RWGC was significantly larger than BMO-MRW (p≤0.003) in every FoBMO segment and RAGC was greater than MRASDOCT superior nasally, RAGC was less than MRASDOCT (Figure 1) inferior temporally. GC versus SDOCT discordance for both RW and RA (Figure 1) were substantial in all quadrants.
SDOCT/CSphoto colocalization and a common, FoBMO-based regionalization strategy has allowed the first precise comparisons between glaucoma clinician and SDOCT rim assessment. Variability among the five GCs in this study was substantial and lead to wide GC versus SDOCT discordance. The source and clinical importance of these differences are under study.
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