April 2011
Volume 52, Issue 14
Free
ARVO Annual Meeting Abstract  |   April 2011
Agreement And Diagnostic Accuracy Of Spectral-domain Optical Coherence Tomography And Confocal Scanning Laser Ophthalmoscopy For Optic Nerve Head Topographical Evaluation
Arthi Balu; Mauro T. Leite; Linda M. Zangwill; Robert N. Weinreb; Pamela A. Sample; Felipe A. Medeiros
Author Affiliations & Notes
  • Arthi Balu
    Hamilton Glaucoma Center, Dept. of Ophthalmology, Univ of Calif, San Diego, California
  • Mauro T. Leite
    Hamilton Glaucoma Center, Dept. of Ophthalmology, Univ of Calif, San Diego, California
    Dept of Ophthalmology, Federal Univ of São Paulo, São Paulo, Brazil
  • Linda M. Zangwill
    Hamilton Glaucoma Center, Dept. of Ophthalmology, Univ of Calif, San Diego, California
  • Robert N. Weinreb
    Hamilton Glaucoma Center, Dept. of Ophthalmology, Univ of Calif, San Diego, California
  • Pamela A. Sample
    Hamilton Glaucoma Center, Dept. of Ophthalmology, Univ of Calif, San Diego, California
  • Felipe A. Medeiros
    Hamilton Glaucoma Center, Dept. of Ophthalmology, Univ of Calif, San Diego, California
    Dept of Ophthalmology, Federal Univ of São Paulo, São Paulo, Brazil
  • Footnotes
    Commercial Relationships  Arthi Balu, None; Mauro T. Leite, None; Linda M. Zangwill, Carl Zeiss Meditec Inc. (F), Heidelberg Engineering (R), Heidelberg Engineering GmbH (F), Optovue Inc. (F), Topcon Medical Systems Inc. (F); Robert N. Weinreb, Alcon Laboratories Inc. (C), Allergan Inc. (C), Carl Zeiss Meditec Inc. (F, C), Heidelberg Engineering GmbH (F), Merck Inc. (C), Novartis (F), Optovue Inc. (F, C), Pfizer Inc. (C), Topocon Medical Systems Inc. (F); Pamela A. Sample, Carl Zeiss Meditec Inc. (F), Haag-Streit (F); Felipe A. Medeiros, Alcon Laboratories Inc. (F, C, R), Allergan Inc. (C, R), Carl Zeiss Meditec Inc. (F, R), Merck Inc. (F), Pfizer Inc. (F, C, R), Reichert Inc. (R)
  • Footnotes
    Support  NEI EY11008, NEI EY08208, and participant retention incentive grants in the form of glaucoma medication at no cost from Alcon Laboratories Inc, Allergan, Pfizer Inc, and Santen Inc.
Investigative Ophthalmology & Visual Science April 2011, Vol.52, 200. doi:
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      Arthi Balu, Mauro T. Leite, Linda M. Zangwill, Robert N. Weinreb, Pamela A. Sample, Felipe A. Medeiros; Agreement And Diagnostic Accuracy Of Spectral-domain Optical Coherence Tomography And Confocal Scanning Laser Ophthalmoscopy For Optic Nerve Head Topographical Evaluation. Invest. Ophthalmol. Vis. Sci. 2011;52(14):200.

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Abstract

Purpose: : To evaluate the agreement and compare the diagnostic abilities of spectral-domain optical coherence tomography and confocal scanning laser ophthalmoscopy for the evaluation of optic nerve head (ONH) parameters.

Methods: : Two hundred and twenty eyes from 140 patients (57 healthy, 83 glaucoma) recruited from the Diagnostic Innovations in Glaucoma Study (DIGS) and the African Descent and Glaucoma Study (ADAGES) were included in this observational cross-sectional study. All participants underwent imaging of the ONH using the Cirrus SDOCT (Carl Zeiss Meditec Inc.) and the Heidelberg Retina Tomograph (HRT; Heidelberg Engineering). Parameters obtained by the instruments and evaluated in this study were disc area, rim area, cup volume and vertical cup-to-disc ratio (VCDR). Agreement between the instruments was evaluated using Bland and Altman plots. Concordance correlation coefficients (CCC) were calculated to evaluate correlations between measurements obtained by each instrument. Age-adjusted areas under receiver operating characteristic curves (AUC) were calculated and compared.

Results: : Measurements obtained with the HRT were, on average, larger for disc area (1.97mm2 vs 1.90mm2; P<0.001) and rim area (1.31mm2 vs 1.10mm2; P<0.001) and significantly smaller for VCDR (0.45 vs 0.58; P<0.001) and cup volume (0.18mm3 vs 0.27mm3; P<0.001) than Cirrus. The CCC ranged from 0.48 for rim area (P<0.001) to 0.79 for disc area (P<0.001). The AUCs for the rim area were significantly larger for the Cirrus compared to the HRT (0.83 vs 0.71; P=0.003). No differences in diagnostic accuracy were found between Cirrus and HRT for the VCDR (AUC: 0.85 vs 0.82; P=0.28) and cup volume parameters (AUC: 0.78 vs 0.77; P=0.52).

Conclusions: : Optic disc measurements obtained with the instruments were not entirely compatible and should not be used interchangeably. For rim area, but not cup-to-disc ratio or cup volume, the Cirrus showed a better performance than the HRT.

Keywords: optic nerve • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • optic disc 
© 2011, The Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Permission to republish any abstract or part of an abstract in any form must be obtained in writing from the ARVO Office prior to publication.
Copyright © 2025 Association for Research in Vision and Ophthalmology.
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