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Hou H, Durbin MK, El-Nimri N, Fischer JL, Sadda SR. Agreement, repeatability, and reproducibility of quantitative retinal layer assessment using swept-source and spectral-domain optical coherence tomography in eyes with retinal diseases. Front Med (Lausanne) 2023; 10:1281751. [PMID: 38164223 PMCID: PMC10757970 DOI: 10.3389/fmed.2023.1281751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 12/04/2023] [Indexed: 01/03/2024] Open
Abstract
Purpose To evaluate the agreement and precision of retinal thickness measurements obtained using swept-source optical coherence tomography (SS-OCT) and spectral-domain OCT (SD-OCT) in healthy eyes and eyes with retinopathy. Methods This cross-sectional prospective study involved three DRI-OCT Triton (SS-OCT) and three 3D-OCT-1 Maestro (SD-OCT) devices. One of each device (Maestro and Triton) was paired with a single operator. Healthy subjects and patients with retinal diseases were recruited, with study eye and testing order randomized. At least 3 scans per eye were captured for wide scan (12 mm × 9 mm-Triton and Maestro) and macular cube scan (7 mm × 7 mm-Triton, 6 mm × 6 mm-Maestro). Thickness of the full retina, ganglion cell layer + inner plexiform layer (GCL+), and ganglion cell complex (GCL++) were obtained from wide scan and cube scans. Agreement of the measurements between the Triton and Maestro was evaluated by Bland-Altman analysis and Deming regression for each group. Repeatability and reproducibility were assessed using a two-way random effect analysis of variance (ANOVA) model for each parameter by group. Results Twenty-five healthy subjects (25 eyes) and 26 patients with retinal diseases (26 eyes), including, but not limited to, age-related macular degeneration, macular hole, and diabetic retinopathy were recruited. Overall, the measurement differences between Triton and Maestro were <6 μm (mean differences of full retina, GCL++, and GCL+ thickness were ≤5.5 μm, 1.3 μm, and 2.8 μm, respectively) and not statistically significant across the parameters. The repeatability and reproducibility estimates indicate high precision in both devices and groups. Across all the parameters, the repeatability limit was ≤7.6 μm for Triton and ≤12.7 μm for Maestro; reproducibility limit was ≤9.2 μm for Triton and ≤14.4 μm for Maestro. In eyes with retinal pathology, the repeatability coefficient of variation (CV)% was ≤2.6% for Triton and ≤3.4% for Maestro; reproducibility CV% was ≤3.3% for Triton and ≤3.5% for Maestro. Conclusion Both Triton SS-OCT and Maestro SD-OCT provide reliable measurements of retinal thickness in healthy eyes and eyes with retinal diseases. Excellent agreement between the two devices indicates interoperability when testing healthy eyes or eyes with retinal pathology. These findings support the use of thickness measurements from Triton SS-OCT and Maestro SD-OCT in clinical practice.
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Affiliation(s)
- Huiyuan Hou
- Topcon Healthcare, Oakland, NJ, United States
| | | | | | | | - Srinivas R. Sadda
- Doheny Eye Institute, Pasadena, CA, United States
- Department of Ophthalmology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
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Paez-Escamilla M, Alabek ML, Beale O, Prensky CJ, Lejoyeux R, Friberg TR, Sahel JA, Rosin B. An Optical Coherence Tomography-Based Measure as an Independent Estimate of Retinal Function in Retinitis Pigmentosa. Diagnostics (Basel) 2023; 13:3521. [PMID: 38066762 PMCID: PMC10706660 DOI: 10.3390/diagnostics13233521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 11/20/2023] [Accepted: 11/20/2023] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND With the clinical advances in the field of gene therapy, the development of objective measures of visual function of patients with inherited retinal dystrophies (IRDs) is of utmost importance. Here, we propose one such measure. METHODS We retrospectively analyzed data from a cohort of 194 eyes of 97 genetically diagnosed patients with retinitis pigmentosa (RP), the most common IRD, followed at the UPMC Vision Institute. The analyzed data included the reflectivity ratio (RR) of the retinal nerve fiber layer (RNFL) to that of the entire retina, visual acuity (VA) and the thickness of the retinal outer nuclear layer (ONL) and the RNFL. RESULTS There was a strong positive correlation between the RR and VA. Both VA and the RR were negatively correlated with disease duration; VA, but not the RR, was negatively correlated with age. The RR correlated with the ONL but not with the RNFL thickness or the intraocular pressure. Age, RR, disease duration and ONL thickness were found to be independent predictors of VA by multivariate analysis. CONCLUSION The OCT RR could serve as an independent predictor of visual acuity, and by extension of retinal function, in genetically diagnosed RP patients. Such objective measures can be of great value in patient selection for therapeutic trials.
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Affiliation(s)
- Manuel Paez-Escamilla
- Department of Ophthalmology/UPMC Vision Institute, University of Pittsburgh Medical Center (UPMC), 1622 Locust Street, Pittsburgh, PA 15219, USA; (M.P.-E.); (M.L.A.); (O.B.); (C.J.P.); (R.L.); (T.R.F.); (J.-A.S.)
- Department of Ophthalmology, McGill University Health Centre, Montreal, QC H4A 3J1, Canada
| | - Michelle L. Alabek
- Department of Ophthalmology/UPMC Vision Institute, University of Pittsburgh Medical Center (UPMC), 1622 Locust Street, Pittsburgh, PA 15219, USA; (M.P.-E.); (M.L.A.); (O.B.); (C.J.P.); (R.L.); (T.R.F.); (J.-A.S.)
| | - Oliver Beale
- Department of Ophthalmology/UPMC Vision Institute, University of Pittsburgh Medical Center (UPMC), 1622 Locust Street, Pittsburgh, PA 15219, USA; (M.P.-E.); (M.L.A.); (O.B.); (C.J.P.); (R.L.); (T.R.F.); (J.-A.S.)
| | - Colin J. Prensky
- Department of Ophthalmology/UPMC Vision Institute, University of Pittsburgh Medical Center (UPMC), 1622 Locust Street, Pittsburgh, PA 15219, USA; (M.P.-E.); (M.L.A.); (O.B.); (C.J.P.); (R.L.); (T.R.F.); (J.-A.S.)
| | - Raphael Lejoyeux
- Department of Ophthalmology/UPMC Vision Institute, University of Pittsburgh Medical Center (UPMC), 1622 Locust Street, Pittsburgh, PA 15219, USA; (M.P.-E.); (M.L.A.); (O.B.); (C.J.P.); (R.L.); (T.R.F.); (J.-A.S.)
- Rothschild Foundation Hospital, 75019 Paris, France
- Institut Oeil Paupiere, Viry-Chatillon, 91170 Paris, France
| | - Thomas R. Friberg
- Department of Ophthalmology/UPMC Vision Institute, University of Pittsburgh Medical Center (UPMC), 1622 Locust Street, Pittsburgh, PA 15219, USA; (M.P.-E.); (M.L.A.); (O.B.); (C.J.P.); (R.L.); (T.R.F.); (J.-A.S.)
| | - Jose-Alain Sahel
- Department of Ophthalmology/UPMC Vision Institute, University of Pittsburgh Medical Center (UPMC), 1622 Locust Street, Pittsburgh, PA 15219, USA; (M.P.-E.); (M.L.A.); (O.B.); (C.J.P.); (R.L.); (T.R.F.); (J.-A.S.)
| | - Boris Rosin
- Department of Ophthalmology/UPMC Vision Institute, University of Pittsburgh Medical Center (UPMC), 1622 Locust Street, Pittsburgh, PA 15219, USA; (M.P.-E.); (M.L.A.); (O.B.); (C.J.P.); (R.L.); (T.R.F.); (J.-A.S.)
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Diagnostic Capability of 3D Peripapillary Retinal Volume for Glaucoma Using Optical Coherence Tomography Customized Software. J Glaucoma 2020; 28:708-717. [PMID: 31180936 PMCID: PMC6727946 DOI: 10.1097/ijg.0000000000001291] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
PRéCIS:: The diagnostic capability of peripapillary retinal volume is similar to peripapillary retinal nerve fiber layer thickness for diagnosing glaucoma, but with fewer artifacts. PURPOSE To compare the diagnostic capability of 3-dimensional peripapillary retinal volume (RV) versus 2-dimensional peripapillary retinal nerve fiber layer (RNFL) thickness for open-angle glaucoma. PATIENTS AND METHODS A retrospective cross-sectional analysis was conducted. A total of 180 subjects (113 open-angle glaucoma, 67 normal participants) had spectral domain optical coherence tomography volume scans and RNFL thickness measurements. Peripapillary RV values were calculated using a custom-designed program with 4 circumpapillary annuli (CA): CA1 had circle diameters of 2.5 and 3.5 mm; CA2, 3 and 4 mm; CA3, 3.5 and 4.5 mm; and CA4, 4 and 5 mm. Area under the receiver operating characteristic curves were calculated for global, quadrant, and octant regions for RV (CA1 to CA4) and RNFL thickness. Pair-wise comparisons were conducted. Artifacts rates were determined. RESULTS Mean age was 62.7±15.4 years, and 47.8% (86/180) were male. Among RV measurements, best diagnostic performances were for the smallest 2 annuli for inferior RV (CA1: 0.964, CA2: 0.955). Of the 4 annuli, CA1 had the highest diagnostic performance. Of specific regions, the inferior RV quadrant had the highest performance across CA1 to CA4. Peripapillary RV had similar diagnostic capability compared with RNFL thickness (P>0.05). The artifact rate per B-scan for RV was 6.0%, which was significantly lower compared with 2-dimensional RNFL thickness in the same patient population (32.2%, P<0.0001). CONCLUSIONS The diagnostic capability of RV is similar to RNFL thickness for perimetric open-angle glaucoma, but RV had fewer artifacts compared with RNFL thickness.
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Wong BM, Cheng RW, Mandelcorn ED, Margolin E, El-Defrawy S, Yan P, Santiago AT, Leontieva E, Lou W, Hatch W, Hudson C. Validation of Optical Coherence Tomography Retinal Segmentation in Neurodegenerative Disease. Transl Vis Sci Technol 2019; 8:6. [PMID: 31588371 PMCID: PMC6753973 DOI: 10.1167/tvst.8.5.6] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 04/24/2019] [Indexed: 01/07/2023] Open
Abstract
Purpose This study assessed agreement between an automated spectral-domain optical coherence tomography (SD-OCT) retinal segmentation software and manually corrected segmentation to validate its use in a prospective clinical study of neurodegenerative diseases (NDD). Methods The sample comprised 30 subjects with NDD, including vascular cognitive impairment, frontotemporal dementia, Parkinson's disease, and Alzheimer's disease. Macular SD-OCT scans were acquired and segmented using Heidelberg Spectralis. For the central foveal B scan of each eye, eight segmentation lines were examined to determine the proportion of each line that the software erroneously delineated. Errors in four lines were manually corrected in all B scans spanning a 6-mm circle centered on the foveola. Mean volume and thickness measurements for four retinal layers (total retina, retinal nerve fiber layer [RNFL], inner retinal layers, and outer retinal layers) were obtained before and after correction. Results The outer plexiform layer line had one of the lowest mean error ratios (2%), while RNFL had the highest (23%). Agreement between automated software and trained observer was excellent (ICC > 0.98) for retinal thickness and volume of all layers. Mean volume differences between software and observers for the four layers ranged from −0.003 to 0.006 mm3. Mean thickness differences ranged from −1.855 to 1.859 μm. Conclusions Despite occasional small errors in software-generated retinal sublayer segmentation, agreement was excellent between software-derived and observer-corrected mean volume and thickness sublayer measurements. Translational Relevance Automated SD-OCT segmentation software generates valid measurements of retinal layer volume and thickness in NDD subjects, thereby avoiding the need to manually correct nonobvious delineation errors.
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Affiliation(s)
- Bryan M Wong
- University of Waterloo, School of Optometry and Vision Science, Waterloo, Ontario, Canada.,University of Toronto, Faculty of Medicine, Toronto, Ontario, Canada
| | - Richard W Cheng
- University of Waterloo, School of Optometry and Vision Science, Waterloo, Ontario, Canada
| | - Efrem D Mandelcorn
- University of Toronto, Department of Ophthalmology and Vision Sciences, Toronto, Ontario, Canada.,Kensington Eye Institute, Toronto, Ontario, Canada
| | - Edward Margolin
- University of Toronto, Department of Ophthalmology and Vision Sciences, Toronto, Ontario, Canada.,Kensington Eye Institute, Toronto, Ontario, Canada
| | - Sherif El-Defrawy
- University of Toronto, Department of Ophthalmology and Vision Sciences, Toronto, Ontario, Canada.,Kensington Eye Institute, Toronto, Ontario, Canada
| | - Peng Yan
- University of Toronto, Department of Ophthalmology and Vision Sciences, Toronto, Ontario, Canada.,Kensington Eye Institute, Toronto, Ontario, Canada
| | - Anna T Santiago
- Baycrest, Rotman Research Institute, Toronto, Ontario, Canada
| | - Elena Leontieva
- University of Waterloo, School of Optometry and Vision Science, Waterloo, Ontario, Canada
| | - Wendy Lou
- University of Toronto, Dalla Lana School of Public Health, Toronto, Ontario, Canada
| | | | - Wendy Hatch
- University of Toronto, Department of Ophthalmology and Vision Sciences, Toronto, Ontario, Canada.,Kensington Eye Institute, Toronto, Ontario, Canada
| | - Christopher Hudson
- University of Waterloo, School of Optometry and Vision Science, Waterloo, Ontario, Canada.,University of Toronto, Department of Ophthalmology and Vision Sciences, Toronto, Ontario, Canada
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Manousaridis K, Peter-Reichart S, Mennel S. Ocriplasmin treatment for vitreomacular traction in real life: can the indication spectrum be expanded? Graefes Arch Clin Exp Ophthalmol 2017; 255:1907-1916. [PMID: 28681138 DOI: 10.1007/s00417-017-3731-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 06/13/2017] [Accepted: 06/20/2017] [Indexed: 10/19/2022] Open
Abstract
PURPOSE To evaluate the efficacy of intravitreal ocriplasmin for the resolution of vitreomacular traction (VMT) with or without a full thickness macular hole (FTMH) in the clinical setting and to assess whether the indication spectrum of this treatment modality can be expanded beyond that of the MIVI-TRUST trials. METHODS The records of patients with VMT with or without FTMH, who were treated with intravitreal ocriplasmin were reviewed. Patients were divided in two groups. In the first group, VMT with or without FTMH was present without any other macular pathology. In the second group, VMT with or without FTMH occurred alongside of other macular disease including age-related macular degeneration, diabetic maculopathy and post-operative pseudophakic cystoid macular edema. RESULTS Release of the VMT was achieved in 12/20 patients (12/20 eyes) of the first group. 16 eyes in this group met 3 or more criteria known to be associated with favorable prognosis after intravitreal ocriplasmin treatment. No cases of release of the VMT were observed in the second group, which included 15 patients (15 eyes). Significant improvement of visual acuity and reduction of the central macular thickness was observed only in the subgroup of eyes which responded to treatment. CONCLUSIONS Concomitant macular pathology was a significant factor for treatment failure and we suggest that ocriplasmin should be regarded with caution in these cases. Careful patient selection for treatment with ocriplasmin using specific criteria in the clinical setting can provide superior results to those reported in the MIVI-TRUST trials.
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Affiliation(s)
- Kleanthis Manousaridis
- Ophthalmology Department, State Hospital Feldkirch, Academic Teaching Hospital, Carinagasse 47, 6800, Feldkirch, Austria.
| | - Silvia Peter-Reichart
- Ophthalmology Department, State Hospital Feldkirch, Academic Teaching Hospital, Carinagasse 47, 6800, Feldkirch, Austria
| | - Stefan Mennel
- Ophthalmology Department, State Hospital Feldkirch, Academic Teaching Hospital, Carinagasse 47, 6800, Feldkirch, Austria
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Hanumunthadu D, Ilginis T, Restori M, Sagoo MS, Tufail A, Balaggan KS, Patel PJ. Repeatability of swept-source optical coherence tomography retinal and choroidal thickness measurements in neovascular age-related macular degeneration. Br J Ophthalmol 2016; 101:603-608. [PMID: 27491359 DOI: 10.1136/bjophthalmol-2016-308999] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Revised: 06/28/2016] [Accepted: 07/14/2016] [Indexed: 11/03/2022]
Abstract
BACKGROUND The aim was to determine the intrasession repeatability of swept-source optical coherence tomography (SS-OCT)-derived retinal and choroidal thickness measurements in eyes with neovascular age-related macular degeneration (nAMD). METHODS A prospective study consisting of patients with active nAMD enrolled in the Distance of Choroid Study at Moorfields Eye Hospital, London. Patients underwent three 12×9 mm macular raster scans using the deep range imaging (DRI) OCT-1 SS-OCT (Topcon) device in a single imaging session. Retinal and choroidal thicknesses were calculated for the ETDRS macular subfields. Repeatability was calculated according to methods described by Bland and Altman. RESULTS 39 eyes of 39 patients with nAMD were included with a mean (±SD) age of 73.9 (±7.2) years. The mean (±SD) retinal thickness of the central macular subfield was 225.7 μm (±12.4 μm). The repeatability this subfield, expressed as a percentage of the mean central macular subfield thickness, was 23.2%. The percentage repeatability of the other macular subfields ranged from 13.2% to 28.7%. The intrasession coefficient of repeatability of choroidal thickness of the central macular subfield was 57.2 μm with a mean choroidal thickness (±SD) of 181 μm (±15.8 μm). CONCLUSIONS This study suggests that a change >23.2% of retinal thickness and 57.2 μm choroidal thickness in the central macular subfield is required to distinguish true clinical change from measurement variability when using the DRI OCT-1 device to manage patients with nAMD.
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Affiliation(s)
- Daren Hanumunthadu
- NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - Tomas Ilginis
- NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - Marie Restori
- NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - Mandeep S Sagoo
- NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK.,Ophthalmology Department, Barts Health NHS Trust, London, UK
| | - Adnan Tufail
- NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - Kamaljit S Balaggan
- NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK.,Wolverhampton and Midland Counties Eye Infirmary, Wolverhampton, UK
| | - Praveen J Patel
- NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
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Hanumunthadu D, Ilginis T, Restori M, Sagoo M, Tufail A, Balaggan KS, Patel PJ. Spectral-domain Optical Coherence Tomography Retinal and Choroidal Thickness Metric Repeatability in Age-related Macular Degeneration. Am J Ophthalmol 2016; 166:154-161. [PMID: 27066726 DOI: 10.1016/j.ajo.2016.03.052] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 03/31/2016] [Accepted: 03/31/2016] [Indexed: 11/26/2022]
Abstract
PURPOSE To determine the intrasession repeatability of spectral-domain OCT (SDOCT)-derived macular retinal and choroidal metrics in patients with neovascular age-related macular degeneration (nAMD) in the Distance of Choroid Study (DOCS). DESIGN Validity and reliability analysis. METHODS Enrolled patients underwent repeated SDOCT imaging using the Spectralis OCT (Heidelberg Engineering, Heidelberg, Germany). A single technician certified for clinical trials took 3 macular volume scans. Retinal thicknesses were calculated for each of the 9 Early Treatment Diabetic Retinopathy Study (ETDRS) macular subfields. Center point thickness and total macular volume were also included in the analysis. Manual subfoveal choroidal thickness measurements were made by a masked observer. RESULTS A total of 40 eyes of 40 patients were included in this analysis (mean [± standard deviation] age: 74.1 [± 7.2] years, 60% male). The coefficient of repeatability (CR) of the central macular subfield was 30.6 μm (95% confidence interval [CI] 29.8-1.4 μm). The CR for the other macular subfields ranged from 7.0 μm to 38.2 μm. The CR for the total macular volume was 0.212 mm(3) (95% CI 0.206-0.217 mm(3)) and the CR for the center point was 47.5 μm (95% CI 46.2-48.7 μm). Images were also reviewed for the presence of segmentation error in the central macular subfield, and after exclusion of these eyes the revised CR for this subfield was 13.7 μm (95% CI 13.3-14.1 μm). The intrasession CR of subfoveal choroidal thickness was 34.7 μm (95% CI 33.7-35.7 μm). CONCLUSIONS This study suggests that a change of greater than 31 μm in Spectralis SDOCT-derived retinal thickness measurement of the central macular subfield and 35 μm in subfoveal choroidal thickness is necessary to detect true clinical change associated with disease progression or improvement in nAMD with a revised figure of 14 μm for central macular retinal subfield thickness in the absence of segmentation error.
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