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

Min Seok Kang; Seung-Young Yu; Hyung Woo Kwak

doi:10.3341/jkos.2016.57.5.786

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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

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.

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.

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
Subfield	Layer segmentation	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
Subfield	Layer segmentation	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.

Table 4.

Repeatability of thickness measurements for 5 intra-retinal layers in the outer circle

Subfield	Layer segmentation	Inter-session
Subfield	Layer segmentation	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.

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