Comparison of Spectral-Domain Optical Coherence Tomography and Heidelberg Retina Tomograph III Optic Nerve Head Parameters in Glaucoma

Abstract

Background: To evaluate the agreement between the optic nerve head (ONH) measurements obtained by spectral-domain optical coherence tomography/scanning laser ophthalmoscope (SD-OCT/SLO) and the Heidelberg retinal tomograph III (HRT-III), and to compare the ONH measurements of both devices in different glaucoma types. Methods: In a prospective study, 30 patients with primary open-angle glaucoma (POAG) and 30 patients with pseudoexfoliation glaucoma (PXG) were enrolled. All patients underwent SD-OCT/SLO and HRT-III evaluation of the ONH during the same visit. Agreement between measurements of SD-OCT/SLO and HRT-III were evaluated by determination of intraclass correlation coeficients. In addition, mean ONH measurements obtained with both devices were compared between POAG and PXG patient groups. Results: Mean SD-OCT/SLO measurements were greater than those of HRT-III, except for mean and maximum cup depth. Intraclass correlation coefficient values for disc area, rim area, cup area, cup/disc area ratio, mean cup depth and maximum cup depth were 0.367, 0.213, 0.632, 0.681, 0.775 and 0.661, respectively. No significant differences were found between ONH parameters of POAG and PXG patients as measured with both devices (p > 0.01). Conclusion: ONH measurements with SD-OCT/SLO and HRT-III did not show clinically acceptable agreement in glaucoma patients. This precludes interchangeable use of these measurements in clinical practice. PXG and POAG patient groups displayed similar ONH measurements with both devices.

Comparing Optic Nerve Head Analysis Between Confocal Scanning Laser Ophthalmoscopy and Spectral Domain Optical Coherence Tomography

“…13 Hence, cup measurements are higher by RTVue-100 than HRT3, and rim measurements are higher by HRT3 than RTVue-100. 14 Tan et al 15 already demonstrated that HRT rim area has the highest variability due to reference plane position. In fact, rim area is measured where the reference plane intersects the ONH on the z-axis, so any z-axis shifts between the ONH and the reference plane due to variation in ONH and peripapillary topography, reference plane or both, could affect rim area measurements.…”

Diagnostic Consistency and Relation Between Optical Coherence Tomography and Standard Automated Perimetry in Primary Open-Angle Glaucoma

“…4,5,7 A new generation of SD-OCT devices provide highquality images of retinal layers and allow quantitative assessment of RNFL and ONH. 12,13 Although SD-OCT is an effective technology for supplying structural data, clinicians hope to verify structural damage with corresponding functional changes. Standard automated perimetry is the main method for detecting functional glaucomatous damage, whereas it was suggested that clinically relevant VF defect usually manifests many years after initial structural damage.…”

New Frontiers in Retinal Imaging

“…Taking advantage of the principle of confocal microscopy, confocal SLO moves a confocal aperture between two end points to obtain a number of tomographic slices and to extract depth information [21,22] . Confocal SLO and OCT have become standard instruments for scanning the optic nerve head in glaucoma and are widely being used for imaging the RNFL [23,24] . Another important feature of SLO is the use of different wavelength lasers to enable a pseudocolor fundus image.…”

“…The Optos captures an appreciably wider view of the retina temporally and nasally, despite of peripheral distortion, while the ultra-wide field Heidelberg Spectralis is able to image the superior and inferior retinal vasculature more peripherally [53] . Of note, the Heidelberg Spectralis provides a higher resolution image than that of Optos [23] . Recent advances in UWF imaging software, such as stereographic projection software, now have been available in commercial UWF devices.…”