Reproducibility of Peripapillary Retinal Nerve Fiber Layer Thickness Measured by Spectral Domain Optical Coherence Tomography in Pseudophakic Eyes
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Purpose: To assess the reproducibility of circumpapillary retinal nerve fiber layer (cpRNFL) thickness measurement(measurement agreement) and its color-coded classification (classification agreement) by Cirrus spectraldomainoptical coherence tomography (OCT) in pseudophakic eyes. Methods: Two-hundred five participants having glaucoma or glaucoma suspected eyes underwent two repeatedCirrus OCT scans to measure cpRNFL thickness (optic disc cube 200 × 200). After classifying participantsinto three different groups according to their lens status (clear media, cataract, and pseudophakic), values ofintra-class coefficient (ICC), coefficient of variance, and test-retest variability were compared between groupsfor average retinal nerve fiber layer (RNFL) thicknesses and that corresponding to four quadrant maps. Linearweighted kappa coefficients were calculated as indicators of agreement of color code classification in eachgroup. Results: ICC values were all excellent (generally defined as 0.75 to 1.00) for the average and quadrant RNFLthicknesses in all three groups. ICC values of the clear media group tended to be higher than those in the cataractand pseudophakic groups for all quadrants and average thickness. Especially in the superior and nasalquadrants, the ICC value of the cataract group was significantly lower than that of the clear media and pseudophakicgroups. For average RNFL thickness, classification agreement (kappa) in three groups did not showa statistically significant difference. For quadrant maps, classification agreement (kappa) in the clear mediagroup was higher than those in the other two groups. Conclusions: Agreement of cpRNFL measurement and its color code classification between two repeated CirrusOCT scans in pseudophakic eyes was as good as that in eyes with clear crystalline lens. More studies arerequired to ascertain the effect of lens status on the reproducibility of Cirrus OCT according to different stagesof glaucoma patients.
Abstract
Purpose: To assess the reproducibility of circumpapillary retinal nerve fiber layer (cpRNFL) thickness measurement(measurement agreement) and its color-coded classification (classification agreement) by Cirrus spectraldomainoptical coherence tomography (OCT) in pseudophakic eyes. Methods: Two-hundred five participants having glaucoma or glaucoma suspected eyes underwent two repeatedCirrus OCT scans to measure cpRNFL thickness (optic disc cube 200 × 200). After classifying participantsinto three different groups according to their lens status (clear media, cataract, and pseudophakic), values ofintra-class coefficient (ICC), coefficient of variance, and test-retest variability were compared between groupsfor average retinal nerve fiber layer (RNFL) thicknesses and that corresponding to four quadrant maps. Linearweighted kappa coefficients were calculated as indicators of agreement of color code classification in eachgroup. Results: ICC values were all excellent (generally defined as 0.75 to 1.00) for the average and quadrant RNFLthicknesses in all three groups. ICC values of the clear media group tended to be higher than those in the cataractand pseudophakic groups for all quadrants and average thickness. Especially in the superior and nasalquadrants, the ICC value of the cataract group was significantly lower than that of the clear media and pseudophakicgroups. For average RNFL thickness, classification agreement (kappa) in three groups did not showa statistically significant difference. For quadrant maps, classification agreement (kappa) in the clear mediagroup was higher than those in the other two groups. Conclusions: Agreement of cpRNFL measurement and its color code classification between two repeated CirrusOCT scans in pseudophakic eyes was as good as that in eyes with clear crystalline lens. More studies arerequired to ascertain the effect of lens status on the reproducibility of Cirrus OCT according to different stagesof glaucoma patients.
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