Journal List > J Korean Ophthalmol Soc > v.54(9) > 1009475

J Korean Ophthalmol Soc. 2013 Sep;54(9):1365-1370. Korean.
Published online September 14, 2013.  https://doi.org/10.3341/jkos.2013.54.9.1365
Copyright © 2013 The Korean Ophthalmological Society
Reproducibility of Choroidal Thickness in Normal Korean Eyes Using Two Spectral Domain Optical Coherence Tomography
Kwang Hyun Lee, MD, Sung Chul Lee, MD and Christopher Seungkyu Lee, MD
Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea.

Address reprint requests to Christopher Seungkyu Lee, MD. Department of Ophthalmology, Severance Hospital, #50 Yonsei-ro, Seodaemun-gu, Seoul 120-749, Korea. Tel: 82-2-2228-3570, Fax: 82-2-312-0541, Email: sklee219@yuhs.ac
Received February 02, 2013; Revised May 03, 2013; Accepted July 23, 2013.

Abstract

Purpose

To investigate the reproducibility of choroidal thickness measurements in healthy Koreans using two spectral domain optical coherence tomography (SD-OCT) instruments: Zeiss Cirrus HD-OCT (Carl Zeiss Meditec Inc., Dublin, CA, USA) and Heidelberg Spectralis (Heidelberg Engineering, Heidelberg, Germany).

Methods

Images were obtained in 60 eyes of 30 healthy undilated volunteers without ocular pathology in a clinical setting. The choroid was imaged in all subjects using Cirrus HD 1-line raster and Spectralis enhanced depth imaging (EDI). The choroid was measured subfoveally, 1500 µm temporal, and 1500 µm nasal to the fovea. All measurements were performed by two independent observers. One-way analysis of variance (ANOVA), Pearson correlation, and Bland-Altman analysis were used to compare measurements.

Results

The study group consisted of 15 males and 15 females. The mean age was 50.73 ± 15.09 years (range, 24-75 years). There was no significant difference in the mean choroidal thickness (p > 0.05) between systems for any location. The choroidal thickness measurements using two instruments (Cirrus vs. Spectralis) were also strongly correlated (p < 0.001).

Conclusions

In the present study of healthy Korean adults, good reproducibility was observed between choroidal thickness measurements of images obtained from Cirrus and Spectralis.

Keywords: Choroidal thickness; Optical coherence tomography; Reproducibility of results

Figures


 Figure 1
Optical coherence tomography scans showing choroidal thicknesses of the same subject on Cirrus and Spectralis. (A) An OCT image of the subject on Cirrus (Carl Zeiss Meditec Inc., Dublin, CA). Image averaging is used for choroidal visualization. choroidal thickness measurements was taken perpendicularly from the outer edge of the hyper-reflective retinal pigment epithelium to the inner sclera at the fovea, 1500 µm temporal to the fovea, and 1500 µm nasal to the fovea. (B) An OCT image of subject on Spectralis. Image averaging with the aid of the eye tracking and EDI are used for choroidal visualization. Choroidal thickness measurements was taken at the fovea, 1500 µm temporal to the fovea, and 1500 µm nasal to the fovea (CTN: choroidal thickness measured at 1.5 mm nasal to the fovea, CTF subfoveal choroidal thickness, CTT choroidal thickness measured at 1.5 mm temporal to the fovea).
Click for larger image


Figure 2
Graph showing mean choroidal thickness measurement in normal eyes at the fovea, 1.5 mm nasal to the fovea, and 1.5 mm temporal to the fovea.
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Figure 3
Bland-Altman plots for Cirrus vs. Spectralis. (A) Bland-Altman plot for subfoveal choroidal thickness. Mean difference is 2.425 (95% CI -0.174 to 5.024). The 95% limits of agreement for choroidal thickness measurements are -17.694 to 22.544. (B) Bland-Altman plot for choroidal thickness of the nasal fovea. Mean difference is 0.733 (95% CI -1.489 to 2.956). The 95% limits of agreement are -16.476 to 17.942. (C) Bland-Altman plot forchoroidal thickness of the temporal fovea. Mean difference is 1.292 (95% CI -1.659 to 4.242). The 95% limits of agreement for choroidal thickness measurements between Cirrus and Spectralis are -21.549 to 24.133.
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Tables


 Table 1
Inter-grader comparison of choroidal thickness measurements for cirrus and spectralis
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Table 2
Summary of previous studies on demographics and choroidal thickness measurements using various optical coherence tomographies in normal subjects
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Notes

The Association for Research in Vision and Ophthalmology Annual Meeting, May, 6-10, 2012, Fort Lauderdale, Florida.

References
1. Torres VL, Brugnoni N, Kaiser PK, Singh AD. Optical coherence tomography enhanced depth imaging of choroidal tumors. Am J Ophthalmol 2011;151:586–593.e2.
2. Spaide RF. Age-related choroidal atrophy. Am J Ophthalmol 2009;147:801–810.
3. Gemenetzi M, De Salvo G, Lotery AJ. Central serous chorioretinopathy: an update on pathogenesis and treatment. Eye (Lond) 2010;24:1743–1756.
4. Spaide RF, Koizumi H, Pozzoni MC. Enhanced depth imaging spectral-domain optical coherence tomography. Am J Ophthalmol 2008;146:496–500.
5. Branchini L, Regatieri CV, Flores-Moreno I, et al. Reproducibility of choroidal thickness measurements across three spectral domain optical coherence tomography systems. Ophthalmology 2012;119:119–123.
6. Manjunath V, Fujimoto JG, Duker JS. Cirrus HD-OCT high definition imaging is another tool available for visualization of the choroid and provides agreement with the finding that the choroidal thickness is increased in central serous chorioretinopathy in comparison to normal eyes. Retina 2010;30:1320–1321.
author reply 1321-2.
7. Manjunath V, Taha M, Fujimoto JG, Duker JS. Choroidal thickness in normal eyes measured using Cirrus HD optical coherence tomography. Am J Ophthalmol 2010;150:325–329.e1.
8. Yamashita T, Yamashita T, Shirasawa M, et al. Repeatability and reproducibility of subfoveal choroidal thickness in normal eyes of Japanese using different SD-OCT devices. Invest Ophthalmol Vis Sci 2012;53:1102–1107.
9. Benavente-Pérez A, Hosking SL, Logan NS, Bansal D. Reproducibility-repeatability of choroidal thickness calculation using optical coherence tomography. Optom Vis Sci 2010;87:867–872.
10. Carrasco S, Torres JP, Torner L, et al. Enhancing the axial resolution of quantum optical coherence tomography by chirped quasi-phase matching. Opt Lett 2004;29:2429–2431.
11. Fujiwara T, Imamura Y, Margolis R, et al. Enhanced depth imaging optical coherence tomography of the choroid in highly myopic eyes. Am J Ophthalmol 2009;148:445–450.
12. Ikuno Y, Maruko I, Yasuno Y, et al. Reproducibility of retinal and choroidal thickness measurements in enhanced depth imaging and high-penetration optical coherence tomography. Invest Ophthalmol Vis Sci 2011;52:5536–5540.
13. Imamura Y, Fujiwara T, Margolis R, Spaide RF. Enhanced depth imaging optical coherence tomography of the choroid in central serous chorioretinopathy. Retina 2009;29:1469–1473.
14. Imamura Y, Iida T, Maruko I, et al. Enhanced depth imaging optical coherence tomography of the sclera in dome-shaped macula. Am J Ophthalmol 2011;151:297–302.
15. Ikuno Y, Kawaguchi K, Nouchi T, Yasuno Y. Choroidal thickness in healthy Japanese subjects. Invest Ophthalmol Vis Sci 2010;51:2173–2176.
16. Manjunath V, Goren J, Fujimoto JG, Duker JS. Analysis of choroidal thickness in age-related macular degeneration using spectral-domain optical coherence tomography. Am J Ophthalmol 2011;152:663–668.
17. Hirata M, Tsujikawa A, Matsumoto A, et al. Macular choroidal thickness and volume in normal subjects measured by swept-source optical coherence tomography. Invest Ophthalmol Vis Sci 2011;52:4971–4978.
18. Margolis R, Spaide RF. A pilot study of enhanced depth imaging optical coherence tomography of the choroid in normal eyes. Am J Ophthalmol 2009;147:811–815.
19. Kim SW, Oh J, Kwon SS, et al. Comparison of choroidal thickness among patients with healthy eyes, early age-related maculopathy, neovascular age-related macular degeneration, central serous chorioretinopathy, and polypoidal choroidal vasculopathy. Retina 2011;31:1904–1911.
20. Esmaeelpour M, Povazay B, Hermann B, et al. Three-dimensional 1060-nm OCT: choroidal thickness maps in normal subjects and improved posterior segment visualization in cataract patients. Invest Ophthalmol Vis Sci 2010;51:5260–5266.
21. Ding X, Li J, Zeng J, et al. Choroidal thickness in healthy Chinese subjects. Invest Ophthalmol Vis Sci 2011;52:9555–9560.
22. Li XQ, Larsen M, Munch IC. Subfoveal choroidal thickness in relation to sex and axial length in 93 Danish university students. Invest Ophthalmol Vis Sci 2011;52:8438–8441.
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