Reproducibility of Optical Coherence Tomography in Multiple Sclerosis

Abstract

Background: Optical coherence tomography (OCT) is a promising new method of quantifying axon thickness in the retinal nerve fiber layer (RNFL) that has been used predominantly by ophthalmologists to monitor glaucoma. Optical coherence tomography is being considered as a potential outcome measure in multiple sclerosis (MS) clinical trials, but no data exist on the reproducibility of this technique in MS centers. Objective: To determine the reproducibility of OCT measurement of mean RNFL thickness in the undilated eyes of healthy control subjects and patients with MS. Design: Prospective analysis of 4 healthy controls to determine interrater, intrarater, and longitudinal reproducibility. Cross-sectional analysis of 3 cohorts of patients with MS (n=396) and healthy controls (n = 153). Setting: Multiple sclerosis clinics at 3 academic medical centers. Patients or Other Participants: Healthy controls and patients with MS. Main Outcome Measure: Thickness of RNFL. Results: We found excellent agreement with respect to interrater (intraclass correlation [ICC], 0.89), intrarater (ICC, 0.98), and intervisit (ICC, 0.91) results. Mean RNFL thickness did not vary significantly among research centers for patients with MS (93, 92, and 90 µm) or among healthy controls (103, 105, and 104 µm) by site. Conclusions: We demonstrate that mean RNFL thickness can be reproducibly measured by trained technicians in an MS center using the OCT-3 model. The RNFL measures from cohorts of age-matched controls and patients with MS from 3 different research centers were remarkably similar.

Optical Coherence Tomography (OCT): Imaging the Visual Pathway as a Model for Neurodegeneration

“…Previous work by Cettomai et al [16] showed good levels of inter-rater and test-retest reliability for OCT 3 (Stratus) measurements of RNFL thickness in patients with MS and disease-free controls. A more recent study, however, demonstrated that high-resolution Fourier domain OCT techniques afford an even greater degree of reproducibility of RNFL thickness and macular volume assessments [32].…”

Comparison of retinal nerve fiber layer measured by time domain and spectral domain optical coherence tomography in optic neuritis

“…These OCTs offer faster scan speed and higher image resolution for RNFL imaging than conventional time-domain OCT. 2 Several studies have focused on the measurements and reproducibility of RNFL thickness using Stratus-OCT after optic neuritis (ON) and multiple sclerosis (MS). [3][4][5][6][7][8][9][10][11][12][13] In fact, lower RNFL values correlate with impaired visual function. OCT is a promising tool for evaluating atrophy in patients with ON and MS, and it could evolve into an important primary or secondary outcome measure for MS clinical trials and patient care.…”

Stratus OCT Quality Control in Two Multi-Centre Multiple Sclerosis Clinical Trials

“…This non-invasive technique thus may be useful in directing clinical response to pharmacotherapy. [1][2][3][4][5][6]16,[18][19][20][21][24][25][26][27][28] Although OCT will not replace MRI as an objective measure of MS progression, it may be a useful adjunct that provides additional information as a potential marker of neuronal pathology.…”

“…Acceptable reproducibility has been reported by experienced centres using the Stratus OCT. 12 It has historically been used to quantify RNFL thinning in patients with multiple sclerosis (MS) and/or optic neuritis under idealized conditions. 1,3,4,[17][18][19][20][21] The Stratus OCT with Retinal Nerve Fibre Layer (RNFL) Normative Database offers clinicians a quantitative tool for the comparison of the retinal nerve fibre layer in the human retina to a database of known normal subjects. 22,23 Trial 1 required a total of 4 scans per visit: Fast Macular Thickness Map (2) and Fast RNFL Thickness (2).…”