Journal List > J Korean Ophthalmol Soc > v.52(10) > 1008901

Kang, Kim, and Lee: The Measurements of Macular Thickness and Volume with SD-OCT in Normal Eyes



We investigated reproducibility and repeatability of average macular thickness and volume measurements in normal eyes with Cirrus HD OCT (optical coherence tomography).


Fifty normal eyes from twenty-five subjects without medical and ocular histories were included. Macular cube 512 × 128 combination scanning using the Cirrus HD OCT was performed for a total of three times on the same visit by an experienced technician. Then other two technicians performed one more macular scanning respectively. Within-results, the intraclass correlation coefficient (ICC) was calculated for each parameter studied to evaluate repeatability and reproducibility. The correlation between macular measurements and demographic variables (age, gender, and spherical equivalent) were also investigated.


The ICCs for intraoperator reproducibility were 0.99 on the average macular thickness and 0.96 on the macular volume. And the ICCs for interoperator repeatability were found to be 0.98 and 0.96, respectively. The ICCs for measurements of nine regional retinal thickness also were higher than 0.90. The retinal thickness was correlated with age, gender and refractive error. However, neither age nor refractive error affected to reproducibility and repeatability.


The retinal thickness and macular volume measurements using Cirrus HD OCT in healthy volunteers showed excellent reproducibility and repeatability. Therefore, Cirrus HD OCT has been recognized as an useful tool for diagnosis and mornitoring of variable maculopathies.


1. Huang J, Liu X, Wu Z, et al. Macular thickness measurements in normal eyes with time-domain and fourier-domain optical coherence tomography. Retina. 2009; 29:980–7.
2. Sayanagi K, Sharma S, Kaiser PK. Comparison of retinal thickness measurements between three-dimensional and radial scans on spectral-domain optical coherence tomography. Am J Ophthalmol. 2009; 148:431–8.
3. Hsu SY, Tung IC, Sheu MM, Tsai RK. Reproducibility of peripapillary retinal nerve fiber layer and macular retinal thickness measurements using optical coherence tomography. Kaohsiung J Med Sci. 2006; 22:447–51.
4. Ko BW, Shin YW, Lee JM, et al. Comparison of macular thickness measurements between Fourier-domain and Time-domain Optical coherence tomography in normal eyes and eyes with macular diseases. J Korean Ophthalmol Soc. 2009; 50:1661–8.
5. Ooto S, Hangai M, Sakamoto A, et al. Three-dimensional profile of macular retinal thickness in normal Japanese eyes. Invest Ophthalmol Vis Sci. 2010; 51:465–73.
6. Moon SW, Kim ES, Kim YG, et al. The comparison of macular thickness measurements and repeatabilities between time domain and spectral domain OCT. J Korean Ophthalmol Soc. 2009; 50:1050–9.
7. Wong AC, Chan CW, Hui SP. Relationship of gender, body mass index, and axial length with central retinal thickness using optical coherence tomography. Eye. 2005; 19:292–7.
8. Oh SB, Cho WB, Moon JW, Kim HC. Repeatability and agreement of macular thickness measurement using time domain OCT and spectral domain OCT in normal subjects. J Korean Ophthalmol Soc. 2009; 50:710–6.
9. Menke MN, Dabov S, Knecht P, Sturm V. Reproducibility of retinal thickness measurements in healthy subjects using spectralis optical coherence tomography. Am J Ophthalmol. 2009; 147:467–72.
10. Leung CK, Cheung CY, Weinreb RN, et al. Comparison of macular thickness measurements between time domain- and spectral domain-optical coherence tomography (OCT). Invest Ophthalmol Vis Sci. 2008; 49:4893–7.
11. Han IC, Jaffe GJ. Comparison of spectral- and aberrations optical coherence tomography for retinal thickness measurements in healthy and diseased eyes. Am J Ophthalmol. 2009; 147:847–58.
12. Kiernan DF, Mieler WF, Hariprasad SM. Spectral-domain optical coherence tomography: a comparison of modern high-resolution retinal imaging systems. Am J Ophthalmol. 2010; 149:18–31.
13. Kiernan DF, Hariprasad SM, Chin EK, et al. Prospective comparison of cirrus and stratus optical coherence tomography for quantifying retinal thickness. Am J Ophthalmol. 2009; 147:267–75.
14. Early Treatment Diabetic Retinopathy Study Research Group. Photocoagulation for diabetic macular edema. Early Treatment Diabetic Retinopathy Study report number 1. Arch Ophthalmol. 1985; 103:1796–806.
15. Maldonado MJ, Nieto JC, Diez-Cuenca M, Pinero DP. Repeatability and reproducibility of posterior corneal curvature measurements by combined scanning-slit and placido-disc topography after LASIK. Ophthalmology. 2006; 113:1918–26.
16. Muscat S, Parks S, Kemp E, Keating D. Repeatability and reproducibility of macular thickness measurements with the Humphrey OCT system. Invest Ophthalmol Vis Sci. 2002; 43:490–5.
17. Syc SB, Warner CV, Hiremath GS, et al. Reproducibility of aberrations optical coherence tomography in multiple sclerosis. Mult Scler. 2010; 16:829–39.
18. Müller R, Büttner P. A critical discussion of intraclass correlation coefficients. Stat Med. 1994; 13:2465–76.
19. Polito A, Shah SM, Haller JA, et al. Comparison between retinal thickness analyzer and optical coherence tomography (OCT) for assessment of foveal thickness in eyes with macular disease. Am J Ophthalmol. 2002; 134:240–51.
20. Legarreta JE, Gregori G, Punjabi OS, et al. Macular thickness measurements in normal eyes using spectral domain optical coherence tomography. Ophthalmic Surg Lasers Imaging. 2008; 39:s43–9.
21. Kanai K, Abe T, Murayama K, Yoneya S. Retinal thickness and changes with age. Nippon Ganka Gakkai Zasshi. 2002; 106:162–5.
22. Guedes V, Schuman JS, Hertzmark E, et al. Optical coherence tomography measurement of macular and nerve fiber layer thickness in normal and glaucomatous human eyes. Ophthalmology. 2003; 110:177–89.
23. Panda-Jonas S, Jonas JB, Jakobczyk-Zmija M. Retinal photoreceptor density decreases with age. Ophthalmology. 1995; 102:1853–9.
24. Kashani AH, Zimmer-Galler IE, Shah SM, et al. Retinal thickness analysis by race, gender, and age using stratus OCT. Am J Ophthalmol. 2010; 149:496–502.
25. Shin JH, Lee HJ, Jin KH. The relationship between axial length, refractive power and foveal thickness measured by OCT in Koreans. J Korean Ophthalmol Soc. 2005; 46:701–6.
26. Massin P, Erginay A, Haouchine B, et al. Retinal thickness in healthy and diabetic subjects measured using optical coherence tomography mapping software. Eur J Ophthalmol. 2002; 12:102–8.
27. Salyer DL, Lund TD, Fleming DE, et al. Sexual dimorphism and aromatase in the rat retina. Brain Res Dev Brain Res. 2001; 126:131–6.
28. Keane PA, Mand PS, Liakopoulos S, et al. Accuracy of retinal thickness measurements obtained with Cirrus optical coherence tomography. Br J Ophthalmol. 2009; 93:1461–7.

Figure 1.
Standard output of Cirrus OCT, 512 × 128 macular cube (version, Carl Zeiss Meditec).
Figure 2.
The macular thickness map of the right 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.
Table 1.
Demographics Results
Age (mean ± SD, yr [range]) 34.32 ± 9.30 (24.00∼61.00)
  <35 years 13/25 (52%)
  ≥35 years 12/25 (48%)
Sex (M/F) 8/17
BCVA* (snellen) 1.0
Refractive error (SE, mean ± SD, diopter [range]) −2.97 ± 2.59 (−9.13∼+1.13)
IOP (mean ± SD, mm Hg [range]) 14.54 ± 2.34 (11.00∼20.00)

* BCVA = best corrected visual acuity

SE = spherical equivalent.

Table 2.
Thickness and volume measurements
Measurements Results (mean ± SD)
Foveal thickness (μ m) 256 ± 18.25
Average macular thickness (μ m) 279.64 ± 12.71
Total macular volume (mm2) 10.03 ± 0.48
Thickness measurements (μ m)
 S1 (superior inner) 320.83 ± 15.93
 T1 (temporal inner) 306.78 ± 14.64
 I1 (inferior inner) 314.02 ± 16.27
 N1 (nasal inner) 323.44 ± 18.34
 S2 (superior outer) 278.49 ± 12.60
 T2 (temporal outer) 260.09 ± 18.24
 I2 (inferior outer) 267.96 ± 16.90
 N2 (nasal outer) 297.83 ± 19.23
Table 3.
ICCs and 95% limits of agreements of intraoperator results
Measurements ICC* 95% limits of agreement
Foveal thickness 0.98 0.96∼0.99
Average macular thickness 0.99 0.98∼0.99
Total macular volume 0.96 0.94∼0.97
Thickness measurements
 S1 (superior inner) 0.98 0.97∼0.99
 T1 (temporal inner) 0.98 0.97∼0.99
 I1 (inferior inner) 0.98 0.97∼0.99
 N1 (nasal inner) 0.98 0.97∼0.99
 S2 (superior outer) 0.93 0.89∼0.96
 T2 (temporal outer) 0.97 0.95∼0.98
 I2 (inferior outer) 0.97 0.95∼0.98
 N2 (nasal outer) 0.96 0.94∼0.98

* ICC = intraclass correlation coefficient.

Table 4.
ICCs and 95% limits of agreements of interoperator results
Measurements ICC* 95% limits of agreement
Foveal thickness 0.96 0.93∼0.97
Average macular thickness 0.99 0.98∼0.99
Total macular volume 0.96 0.94∼0.98
Thickness measurements
 S1 (superior inner) 0.98 0.96∼0.99
 T1 (temporal inner) 0.97 0.95∼0.98
 I1 (inferior inner) 0.96 0.94∼0.98
 N1 (nasal inner) 0.98 0.97∼0.99
 S2 (superior outer) 0.95 0.92∼0.97
 T2 (temporal outer) 0.95 0.93∼0.97
 I2 (inferior outer) 0.96 0.93∼0.98
 N2 (nasal outer) 0.98 0.97∼0.99

* ICC = intraclass correlation coefficient.

Table 5.
Comparision of reproducibility (upper) and repeatability (lower) by age and spherical equivalent
Foveal thickness Average macular thickness Total macular volume
Age < 35 years 0.96 (0.92∼0.98) 0.99 (0.98∼0.99) 0.97 (0.95∼0.99)
Age ≥ 35 years 0.96 (0.91∼0.98) 0.96 (0.92∼0.98) 0.97 (0.94∼0.99)
SE* < −5.0 diopter 0.97 (0.95∼0.98) 0.98 (0.97∼0.99) 0.96 (0.93∼0.98)
SE* ≥ −5.0 diopter 0.91 (0.74∼0.98) 1.00 (0.99∼1.00) 0.99 (0.97∼1.00)
Foveal thickness Average macular thickness Total macular volume
Age < 35 years 0.97 (0.94∼0.99) 0.99 (0.98∼1.00) 0.96 (0.92∼0.98)
Age ≥ 35 years 0.98 (0.96∼0.99) 0.98 (0.96∼0.99) 0.97 (0.94∼0.99)
SE* < −5.0 diopter 0.98 (0.96∼0.99) 0.99 (0.98∼0.99) 0.96 (0.94∼0.98)
SE* ≥ −5.0 diopter 0.97 (0.93∼0.99) 1.00 (0.99∼1.00) 0.97 (0.91∼0.99)

Data presented as intraclass correlation coefficient (95% limit of agreement).

* SE = spherical equivalent.

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