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K. M. Winges, G. M. Watson, J. L. Keltner, E. K. Chin, T.-G. Nguyen, E. Redenbo, K. Chandra, D. Harvey, S. S. Park; Comparison of Retinal Nerve Fiber Layer Thickness Measurement by Quadrant Among Commercially Available Optical Coherence Tomography Instruments in Patients With Optic Neuritis and/or Multiple Sclerosis. Invest. Ophthalmol. Vis. Sci. 2010;51(13):658.
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© ARVO (1962-2015); The Authors (2016-present)
To compare measurement by quadrant of retinal nerve fiber layer (RNFL) thickness using five different commercially available optical coherence tomography (OCT) instruments in patients with known history of optic neuritis and/or multiple sclerosis (MS).
In compliance with the Declaration of Helsinki, both eyes of 45 subjects with a history of optic neuritis and/or MS were imaged prospectively with five commercially available OCT instruments: Stratus OCT (Zeiss), 3D OCT-1000 (Topcon), Cirrus (Zeiss), RTVue-100 (Optovue), and Spectralis (Heidelberg). Total RNFL thickness and that of each quadrant (superior, inferior, nasal, temporal) obtained with the five different instruments were compared using randomized block analysis of variance (ANOVA) and post-hoc pairwise tests, with each eye and quadrant analyzed separately.
25 subjects were included in the final data set after excluding eyes with poor image quality or concurrent retinal disease. Overall, there was a statistically significant (p<0.001) difference in total RNFL thickness measured among all five OCT instruments. Variability across instruments persisted when assessing each of the four RNFL quadrants (each eye quadrant p<0.001). In pairwise comparisons between specific instruments, a large number of pairs had significant differences: right eye showed 6 pairs differing superiorly, 4 inferiorly, 7 nasally, and 7 temporally; left eye showed 5 superiorly, 7 inferiorly, 6 nasally, and 6 temporally (p<0.05 adjusted for multiple comparisons). Statistically significant differences between instruments in the right eye did not correlate with those in the left eye.
Both total and quadrant RNFL thickness measurement in eyes of patients with MS and/or optic neuritis vary significantly among commercially available OCT instruments. The differences noted between instruments for the right eye did not correlate with differences noted in the left eye, illustrating the significant challenge of OCT instrument standardization in this patient group.
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