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Kang, Yu, and Kwak: The Repeatability of Retinal Layer Thickness Measurements with Spectral-Domain Optical Coherence Tomography in Normal Eyes
Original Article

J Korean Ophthalmol Soc 2015;57(5):786-793.

Published online: 7 September 2015

DOI: https://doi.org/10.3341/jkos.2016.57.5.786

The Repeatability of Retinal Layer Thickness Measurements with Spectral-Domain Optical Coherence Tomography in Normal Eyes

Min Seok Kang, MD, Seung-Young Yu, MD, PhD, Hyung Woo Kwak, MD, PhD

Department of Ophthalmology, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Korea

Address reprint requests to Hyung Woo Kwak, MD, PhD Department of Ophthalmology, Kyung Hee University Hospital, #23 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Korea Tel: 82-2-958-8451, Fax: 82-2-966-7340 E-mail: syyu@khu.ac.kr

Received 5 November 201521 April 2016       Accepted 22 April 2016

© 2016 The Korean Ophthalmological Society

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/ which perm its unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate the repeatability of retinal layer thickness measurements in normal eyes imaged using spectral domain optical coherence tomography (SD-OCT).

Methods

Sixty-eight eyes of 34 healthy subjects were enrolled in this study. Imaging was performed 4 times using 9 x 9 mm macular scans with SD-OCT (RS 3000 Advance HD OCT, NIDEK, Gamagori, Japan) at the same visit by an experienced examiner. After automatic retinal segmentation (layering) in 5 layers, the thickness of each layer was calculated. Macular thickness of 9 Early Treatment of Diabetic Retinopathy Study (ETDRS)-like regions was obtained. Repeatability for each of the 9 subfield areas was calculated by their repeatability coefficients and intraclass correlation coefficients (ICCs).

Results

There was no significant difference in average retinal thickness and each retinal layer thickness between all measurements acquired by the experienced examiner. The ICCs of retinal layer thickness ranged from 0.826 to 0.847 for the ganglion cell layer + inner plexiform layer, inner nuclear layer + outer plexiform layer and outer nuclear layer + external limiting membrane in the fovea. The ICCs were greater than 0.909 for the other intra-retinal layers in all 9 ETDRS subfield thickness between all measurement pairs.

Conclusions

Excellent repeatability was observed for SD-OCT retinal segmented layer thickness measurements in healthy subjects.

Keywords: Automated segmentation, Intraclass correlation coefficients, Repeatability, Retinal layer thickness, Spectral domain optical coherence tomography

References

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Figure 1.
Early Treatment Diabetic Retinopathy Study (ETDRS) subfield (left eye). F = fovea; S1 = superior inner; T1 = temporal inner; I1 = inferior inner; N1 = nasal inner; S2 = superior outer; T2 = temporal outer; I2 = inferior outer; N2 = nasal outer.
jkos-57-786f1.tif
Figure 2.
Spectral domain optical coherence tomography (SD-OCT) automatic segmentation of the retinal layers in the macula. ILM = inner limiting membrane; RNFL = retinal nerve fiber layer; GCL = ganglion cell layer; IPL = inner plexiform layer; INL = inner nuclear layer; OPL = outer plexiform layer; ONL = outer limiting layer; ELM = external limiting membrane; IS/OS = inner segment/outer segment photoreceptor layer; RPE = retinal pigment epithelium.
jkos-57-786f2.tif
Table 1.
Demographics
Demographics Results
Age (years, range) 32.14 ± 8.24 (23 ~ 58)
Sex (male:female) 19:15
Baseline BCVA (decimal) 0.92 ± 0.08
Refractive error (spherical equivalent, diopter [range]) -2.56 ± 1.94 (-8.75 ~+ 1.50)
Baseline IOP (mm Hg) 13 ± 7

Values are presented as mean ± SD unless otherwise indicated.

BCVA = best corrected visual acuity; IOP = intraocular pressure.

Table 2.
Repeatability of thickness measurements for 5 intra-retinal layers in the fovea
Subfield Layer segmentation Inter-session
Mean ± SD (μm) ICC COV (%)
Fovea TRT 262.78 ± 15.53 0.959 5.91
ILM + RNFL 10.65 ± 1.67 0.834 15.68
GCL + IPL 34.28 ± 6.22 0.847 18.14
INL + OPL 39.34 ± 6.31 0.826 16.04
ONL + ELM 103.17 ± 10.07 0.962 9.76
IS/OS + RPE 77.26 ± 6.02 0.941 7.79

Values are presented as mean ± SD unless otherwise indicated.

ICC = intraclass correlation coefficient; COV = coefficient of variance; TRT = total retinal thickness; ILM = inner limiting membrane; RNFL = retinal nerve fiber layer; GCL = ganglion cell layer; IPL = inner plexiform layer; INL = inner nuclear layer; OPL = outer plexiform layer; ONL = outer limiting layer; ELM = external limiting membrane; IS/OS = photoreceptor inner segment/outer segment; RPE = retinal pigment epithelium.

Table 3.
Repeatability of thickness measurements for 5 intra-retinal layers in the inner circle
Subfield Layer segmentation Inter-session
Mean ± SD (μm) ICC COV(%)
Inner
   Superior TRT 339.68 ± 14.73 0.942 4.34
ILM + RNFL 29.42 ± 2.51 0.951 8.53
GCL + IPL 90.17 ± 3.26 0.968 3.62
INL + OPL 78.35 ± 7.25 0.941 9.25
ONL + ELM 73.76 ± 4.43 0.904 6.01
IS/OS + RPE 70.23 ± 2.02 0.965 2.88
   Nasal TRT 341.07 ± 18.25 0.947 5.35
ILM + RNFL 24.76 ± 0.94 0.958 3.80
GCL + IPL 90.24 ± 3.29 0.969 3.65
INL + OPL 78.22 ± 6.96 0.942 8.90
ONL + ELM 79.31 ± 2.97 0.912 3.71
IS/OS + RPE 71.05 ± 2.31 0.963 3.25
   Inferior TRT 338.44 ± 17.72 0.941 5.24
ILM + RNFL 30.21 ± 1.87 0.949 6.20
GCL + IPL 89.96 ± 3.08 0.952 3.42
INL + OPL 72.83 ± 4.73 0.947 6.50
ONL + ELM 78.48 ± 2.44 0.908 3.11
IS/OS + RPE 69.72 ± 1.96 0.959 2.81
   Temporal TRT 324.30 ± 16.46 0.926 5.08
ILM + RNFL 21.18 ± 0.82 0.937 3.87
GCL + IPL 83.26 ± 2.89 0.928 3.47
INL + OPL 70.88 ± 6.54 0.931 9.23
ONL + ELM 81.07 ± 3.06 0.911 3.77
IS/OS + RPE 70.09 ± 2.17 0.926 3.10

Values are presented as mean ± SD unless otherwise indicated.

ICC = intraclass correlation coefficient; COV = coefficient of variance; TRT = total retinal thickness; ILM = inner limiting membrane; RNFL = retinal nerve fiber layer; GCL = ganglion cell layer; IPL = inner plexiform layer; INL = inner nuclear layer; OPL = outer plexiform layer; ONL = outer limiting layer; ELM = external limiting membrane; IS/OS = photoreceptor inner segment/outer segment; RPE = retinal pigment epithelium.

Table 4.
Repeatability of thickness measurements for 5 intra-retinal layers in the outer circle
Subfield Layer segmentation Inter-session
Mean ± SD (μm) ICC COV(%)
Outer
   Superior TRT 297.53 ± 13.23 0.933 4.45
ILM + RNFL 40.56 ± 4.27 0.948 10.53
GCL + IPL 61.15 ± 2.74 0.957 4.48
INL + OPL 59.30 ± 3.51 0.932 5.92
ONL + ELM 70.24 ± 2.76 0.897 3.92
IS/OS + RPE 68.08 ± 2.01 0.954 2.95
   Nasal TRT 309.12 ± 16.55 0.941 5.35
ILM + RNFL 49.21 ± 5.33 0.950 10.83
GCL + IPL 66.74 ± 3.03 0.962 4.54
INL + OPL 60.83 ± 2.40 0.937 3.95
ONL + ELM 68.56 ± 2.36 0.922 3.44
IS/OS + RPE 67.49 ± 1.97 0.954 2.92
   Inferior TRT 291.71 ± 15.74 0.938 5.40
ILM + RNFL 43.82 ± 5.11 0.948 11.66
GCL + IPL 59.94 ± 1.85 0.951 3.09
INL + OPL 56.73 ± 1.89 0.943 3.33
ONL + ELM 65.20 ± 2.17 0.914 3.33
IS/OS + RPE 68.01 ± 2.09 0.952 3.07
   Temporal TRT 278.27 ± 15.08 0.921 5.42
ILM + RNFL 23.86 ± 1.43 0.934 5.99
GCL + IPL 64.27 ± 2.36 0.932 3.67
INL + OPL 57.74 ± 3.52 0.927 6.10
ONL + ELM 68.91 ± 2.57 0.909 3.73
IS/OS + RPE 66.68 ± 1.99 0.926 2.98

Values are presented as mean ± SD unless otherwise indicated.

ICC = intraclass correlation coefficient; COV = coefficient of variance; TRT = total retinal thickness; ILM = inner limiting membrane; RNFL = retinal nerve fiber layer; GCL = ganglion cell layer; IPL = inner plexiform layer; INL = inner nuclear layer; OPL = outer plexiform layer; ONL = outer limiting layer; ELM = external limiting membrane; IS/OS = photoreceptor inner segment/outer segment; RPE = retinal pigment epithelium.

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