December 2002
Volume 43, Issue 13
ARVO Annual Meeting Abstract  |   December 2002
Observer Dependent Diagnostic Variability of Optic Nerve Head Measurements with Confocal Laser Scanning Tomography
Author Affiliations & Notes
  • M Diestelhorst
    Ophthalmology University of Cologne Cologne Germany
  • RO W Burk
    Ophthalmology Eye Hospital Bielefeld Germany
  • DF Garway-Heath
    Ophthalmology Moorfields Eye-Hospital London United Kingdom
  • JB Jonas
    Ophthalmology Faculty of Clinical Medicine Mannheim Ruprecht-Karls-University Heidelberg Germany
  • CP Jonescu-Cuypers
    Ophthalmology University of Cologne Cologne Germany
  • CY Mardin
    Ophthalmology University Erlangen-Nurnberg Erlangen Germany
  • J Funk
    Ophthalmology Albert-Ludwigs-University of Freiburg Freiburg Germany
  • MM Hermann
    Ophthalmology University of Cologne Cologne Germany
  • Footnotes
    Commercial Relationships   M. Diestelhorst, None; R.O.W. Burk, None; D.F. Garway-Heath, None; J.B. Jonas, None; C.P. Jonescu-Cuypers, None; C.Y. Mardin, None; J. Funk, None; M.M. Hermann, None.
Investigative Ophthalmology & Visual Science December 2002, Vol.43, 1014. doi:
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      M Diestelhorst, RO W Burk, DF Garway-Heath, JB Jonas, CP Jonescu-Cuypers, CY Mardin, J Funk, MM Hermann; Observer Dependent Diagnostic Variability of Optic Nerve Head Measurements with Confocal Laser Scanning Tomography . Invest. Ophthalmol. Vis. Sci. 2002;43(13):1014.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract: : Purpose: To study the investigator-dependent diagnostic variability of optic nerve head measurements with confocal laser scanning tomography (HRT I). Methods: A HRT I (Heidelberg Engineering GmbH, Heidelberg) database with 50 HRT images from 25 adults was independently analysed by 7 masked, experienced ophthalmologists from 6 eye-centres. Images were obtained from healthy volunteers and glaucoma patients. Only refractive error, keratometry and age of the patients were known to the observers. Each examiner was asked to diagnose glaucoma from the HRT I images of the optic nerve heads (ONHs). Inter-, and intra-observer differences were calculated as mean±s.d. of disc area, cup area and other parameters for each investigator using software HRT 2.01. Statistical analysis was performed by means of SPSS (SPSS inc., Chicago). Results: Intra-observer means for disc area [mm2] (n=50) varied from user 1 to 7 (random order) 1.83±0.49 / 2.10±0.46 / 2.14±0.36 / 1.92±0.45 / 2.05±0.49 / 2.06±0.41 / 2.21±0.40 with a mean inter-observer variation of 8.8% (range: 2.3-50.6%). Intra-observer means for cup area were 0.45±0.35 / 0.46±0.37 / 0.43±0.35 / 0.45±0.35 / 0.45±0.35 / 0.44±0.37 / 0.44±0.37 with a mean inter-observer variation of 16.9% (range: 0.7-63.6%). Glaucoma was correctly diagnosed by 2 observers only. 24 healthy ONHs were suspected for glaucoma. Conclusion: The variation of intra-observer mean values of HRT I measurements was higher for disc area than for cup area. The mean inter-observer variation for cup area was greater. The observer dependent diagnostic variability of HRT I measurements may lead to disagreeing results. Our findings confirm that the artificial colour coded HRT I image analysis is not suitable for detecting glaucomatous ONHs when used as single diagnostic method.

Keywords: 430 imaging/image analysis: clinical • 432 imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • 498 optic disc 

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