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Abstract
Purpose
To compare macular thickness measurements obtained from time domain optical coherence tomography (TD-OCT) and 2 spectral domain (SD) OCTs and to evaluate their repeatability and agreement in normal subjects and diabetic macular edema patients.
Methods
Fifty-four healthy, normal subjects and 26 diabetic macular edema patients were participated in this study. In a randomly selected eye from each subject, two serial macular measurements were obtained from TD-OCT (Stratus OCT) and SD-OCTs (Cirrus HD-OCT, Spectralis HRA+OCT) by an experienced technician in random order. Nine areas of macular thickness map and repeatabilities obtained by the 3 OCTs were compared.
Results
In relative repeatability, SD-OCT showed better results overall compared to TD-OCT. Macular thickness was greatest in the Spectralis HRA+OCT in both normal subjects and diabetic macular edema patients, followed by Cirrus HD-OCT and Stratus OCT. In normal subjects, regardless of the type of comparison between the machines there was a statistically significant difference in all 9 areas.
Conclusions
While the TD-OCT and the 2 SD-OCTs are reliable for macular thickness measurement, SD-OCT has better measurement repeatability compared with TD-OCT. Because macular measurements obtained from the 3 OCT systems cannot be interchanged, an effort should be made to standardize the measurement of each system.
References
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Figure 1.
AREDS grid at right used for reporting retinal thickness (F=fovea; S1=superior inner;, N1=nasal inner; I1=inferior inner; T1=temporal inner; S2=superior outer; N2=nasal outer; I2: inferior outer; T2=temporal outer).
Figure 2.
Comparison of macular thickness among the three OCTs in nine areas (A=normal; B=diabetic macular edema) (F=fovea; S1=superior inner; N1= nasal inner; I1=inferior inner; T1=temporal inner; S2=superior outer; N2=nasal outer; I2=inferior outer; T2=temporal outer).
Figure 3.
Comparison of the three OCT's relative repeatability (%) (A=normal; B=diabetic macular edema) (F=fovea; S1=superior inner; N1=nasal inner; I1= inferior inner; T1=temporal inner; S2=superior outer; N2=nasal outer; I2=inferior outer; T2=temporal outer).
Figure 4.
Bland-Altman plots of the three OCTs. The mean difference is represented by the blue solid line and the 95% confidence limits, by the dotted lines (A=normal; B=diabetic macular edema).
Figure 5.
Illustration of how time domain and spectral domain OCT samples the retina differently (Right= SD-OCT; Left=TD-OCT).
Figure 6.
Tomographies of the macula taken by the three OCTs with reference lines. All three anterior lines are similar to the ILM, but each posterior line is situated differently.
Table 1.!
Mean values and reliabilities of macular thickness parameter in Stratus OCT
Table 2.!
Mean values and reliabilities of macular thickness parameter in Cirrus HD-OCT
Table 3.!
Mean values and reliabilities of macular thickness parameter in Spectralis HRA+OCT
Table 4.
Mean and standard deviation of each OCT's macular thickness measurement difference. In the comparison of each OCT's macular thickness, all 9 areas showed a significant difference of p<0.001 (* paired t-test. all of them (9 areas))
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