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Elaine Y. TO, Cong Ye, Marco C. Yu, Chi Pui Pang, Dennis S. Lam, Christopher K. Leung; Retinal Nerve Fiber Layer Imaging with Spectral-Domain Optical Coherence Tomography - Agreement with Optic Disc Photography for Measurement of RNFL Defects. Invest. Ophthalmol. Vis. Sci. 2011;52(14):177.
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To compare the agreement of the area and the angular width of localized retinal nerve fiber layer (RNFL) defects measured with optic disc photography and optical coherence tomography (OCT).
39 localized RNFL defects from 30 eyes of 22 glaucoma patients were identified from a database of 259 color optic disc stereophotographs. These patients had RNFL imaging performed with an SD-OCT. RNFL thickness deviation maps generated by the OCT with abnormal pixels denoted in red (RNFLT below the lower 99% normal distribution) or yellow (RNFLT below the lower 95% normal distribution) was aligned and overlaid with the corresponding optic disc photographs. The area and the angular width were measured and compared between optic disc photographs and the OCT RNFL thickness deviation maps. Their agreement was analyzed with the Bland-Altman plots.
The area and the angular width of RNFL defects measured with the optic disc photographs were 2.45±1.04mm2 and 28.14±12.75°, respectively, which were significantly smaller than those measured by the OCT RNFL thickness deviation map when the RNFL defects were defined in yellow and red (4.03±2.01mm2 and 75.91±45.57°, respectively, both with p<0.001). When the RNFL defects were defined in red, a significant difference in angular width (48.93±28.98°, p=0.004), but not in area (2.40±1.49mm2, p=0.443) was found between the 2 imaging modalities. The agreement between OCT and optic disc photograph measurements of RNFL defects was poor. Larger RNFL defects were associated with greater differences between OCT and optic disc photograph measurements.
Analysis of the OCT RNFL thickness deviation map could reveal additional RNFL abnormalities not detectable in optic disc photographs.
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