Reproducibility of Choroidal Thickness Measurements Across Three Spectral Domain Optical Coherence Tomography Systems

Abstract

Purpose To investigate the reproducibility of choroidal thickness measurements in normal subjects on three Spectral Domain Optical Coherence Tomography (SDOCT) instruments, Zeiss Cirrus HD-OCT (Carl Zeiss Meditec Inc, Dublin, California, USA), Heidelberg Spectralis (Heidelberg Engineering, Heidelberg, Germany) and Optovue RTVue (Optovue Inc., Fremont, CA). Design Cross-sectional non-interventional study Participants Images were obtained in 28 eyes of 28 healthy undilated volunteers without ocular pathology in a clinical setting. Methods All subjects were imaged on the fovea using Cirrus HD 1-line raster, Spectralis enhanced depth imaging and RTVue retina-cross. Main Outcome Measures The choroid was measured subfoveally, 750 μm temporal and 750 μm nasal to the fovea. All measurements were performed by 2 independent observers. Two way analysis of variance (ANOVA) with Bonferroni's post-test, Pearson correlation and the Bland-Altman analysis were used to compare measurements. Results The group of 28 subjects consisted of 7 men and 21 women, with an average age of 35.2 years (range, 23 to 64 years). A two way ANOVA with Bonferroni's post-test revealed no significant difference in the average subfoveal choroidal thickness (P >0.05) between systems for any location: subfoveally, 750μm temporal and 750 μm nasal to the fovea. The measurements of choroidal thickness from any pair of three instruments (Cirrus vs. Spectralis, Cirrus vs. RTVue, Spectralis vs. RTVue) were also strongly correlated. The Pearson correlation between all two system pairs of the three systems was greater than 0.9 p <0.0001. The 95% limits of agreement between four choroidal thickness measurements between Cirrus and RTVue were +11.21% to -13.57% (Bias -1.17), between Spectralis and RTVue +10.85% to -12.45% (Bias -0.80) and between Cirrus and Spectralis +12.81% to -13.33% (Bias -0.25). Conclusions In our population of young healthy adults with normal vision, there was good reproducibility between choroidal thickness measurements of images acquired with Cirrus, Spectralis and RTVue.

Change in subfoveal choroidal thickness in central serous chorioretinopathy following spontaneous resolution and low-fluence photodynamic therapy

“…Previous studies also showed that the measurements of choroidal thickness, using EDI-OCT, have good reproducibility and repeatability. 25,26 Besides, considering the similarity of the normal values of this study and that of the previous studies, measuring error may not be significant. 10,26,27 In conclusion, increased SFCT of patients with CSC was reduced after spontaneous resolution and lowfluence PDT.…”

Choroid thickness and ocular pulse amplitude in migraine during attack

“…The thickness of the choroid at the areas 1500 mm nasal and 1500 mm temporal to the fovea was also examined (Figure 1). Two independent raters (MSD and YT) measured images without the information of the eye or other observer, as described previously 17 and the average of the two measurements was taken; the differences between readings of the masked physicians were found to be within 10% of the mean.…”

Influence of choroidal thickness on subfoveal choroidal thickness measurement repeatability using enhanced depth imaging optical coherence tomography

“…Previous studies excluded eyes with indistinct CSI or extrapolated the CSI. 18,19 Although exclusion of eyes with an indefinite boundary could result in higher repeatability, it might not reflect the practical aspects and cause selection bias. Hence, the current study adopted the extrapolation method, because the indistinct CSI should be considered a significant factor in measurement error.…”

“…Two previous investigations revealed high reliability and a strong correlation when comparing repeatability after scanning with three different SD-OCT devices. 18,19 Yamashita et al, 18 however, only considered eyes for which a distinct choroid boundary was seen by both observers, and Branchini et al 19 also averaged the measurements of two observers. Consequently, their studies had a greater tendency to overestimate repeatability than ours.…”