Comparison of the Diagnostic Accuracies of the Spectralis, Cirrus, and RTVue Optical Coherence Tomography Devices in Glaucoma

Abstract

Purpose To compare the diagnostic accuracies of retinal nerve fiber layer (RNFL) thickness measurements obtained with Spectralis (Heidelberg Engineering, Dossenheim, Germany), Cirrus (Carl Zeiss Meditec, Dublin, CA) and RTVue (Optovue Inc, Fremont, CA) for the detection of glaucoma. Design Diagnostic, case-control study Participants Two hundred thirty three eyes (107 healthy, 126 glaucomatous) of 149 participants from the longitudinal Diagnostic Innovations in Glaucoma Study (DIGS) and from the African Descent and Glaucoma Evaluation Study (ADAGES). Methods All participants underwent retinal nerve fiber layer (RNFL) thickness imaging with Spectralis, Cirrus and RTVue in the same visit. Receiver operating characteristic (ROC) curves adjusted for age and race were obtained for quadrants (superior, nasal, inferior, temporal) and global RNFL thickness for all instruments. Areas under ROC (AUC) and sensitivities at fixed specificities (80% and 95%) were calculated and compared. Main Outcome measure Comparison of diagnostic accuracy using AUCs and sensitivities at fixed specificities of 80% and 95%. Results The RNFL thickness parameter with the largest AUCs was the superior quadrant for the Spectralis (0.88) and the global RNFL thickness for the Cirrus (0.88) and the RTVue (0.87). The pair-wise comparison among the ROC curves showed no statistical difference for all parameters except for the nasal quadrant, which had significantly larger AUC in Spectralis and RTVue compared to Cirrus (P<0.03 for both comparisons). There were no significant differences in sensitivities among the best parameters from each instrument (P>0.05). The superior quadrant thickness measured with Spectralis had sensitivity of 81.9% at a fixed specificity of 80% and 70% at a fixed specificity of 95%. The global thickness measured by the Cirrus had a sensitivity of 80.3% at a fixed specificity of 80% and 65.6% at a fixed specificity of 95%. For the RTVue, the global thickness had a sensitivity of 77.9% at a fixed specificity of 80% and 62.1% at a fixed specificity of 95%. Conclusion Although the spectral-domain OCTs have different resolution and acquisition rates, their ability to detect glaucoma was similar.

Quantitative analysis of the intraretinal layers and optic nerve head using ultra-high resolution optical coherence tomography

“…USA) and others, have achieved approximately 5 μm axial resolution. [40][41][42] There are two commercially available ultra-high resolution OCT devices with an axial resolution of approximately 3 μm, including the Biotigen SD-OCT (Bioptigen Inc., Research Triangle Park, NC) 43,44 and the Copernicus HR SOCT (Optopol Technology SA, Zawiercie, Poland). 45 With these devices, the quality of retinal OCT images have been dramatically improved compared to time-domain OCT devices, such as the Stratus OCT (Carl Zeiss Meditec, Dublin, CA).…”

Retinal nerve fibre layer thickness values and their associations with ocular and systemic parameters in Black South Africans

“…4 Optical coherence tomography (OCT) is a non-invasive, non-contact imaging technique that provides real time, objective and in-vivo cross-sectional images of the retina and its sub-structures, being useful to diagnose and manage a variety of retinal diseases and glaucoma. 5 OCT works on the principle of interferometry, which uses reflected light to determine the interface between different ocular tissues and create a cross-sectional image (tomogram) of the tissue of interest. 5 The RNFL fibres appear as a highly reflective layer due to their unique perpendicular arrangement in relation to the direction of the OCT light beam, which allows its borders to be automatically detected and its thickness measured using computer al-gorithms.…”

“…5 OCT works on the principle of interferometry, which uses reflected light to determine the interface between different ocular tissues and create a cross-sectional image (tomogram) of the tissue of interest. 5 The RNFL fibres appear as a highly reflective layer due to their unique perpendicular arrangement in relation to the direction of the OCT light beam, which allows its borders to be automatically detected and its thickness measured using computer al-gorithms. 5 The recently developed spectral domain (SD-OCT) technology 5 has a five times higher image resolution and 60 times faster imaging speed compared with the conventional time domain (TD-OCT) devices, resulting in improved diagnostic accuracy in detecting early glaucoma.…”

“…5 The RNFL fibres appear as a highly reflective layer due to their unique perpendicular arrangement in relation to the direction of the OCT light beam, which allows its borders to be automatically detected and its thickness measured using computer al-gorithms. 5 The recently developed spectral domain (SD-OCT) technology 5 has a five times higher image resolution and 60 times faster imaging speed compared with the conventional time domain (TD-OCT) devices, resulting in improved diagnostic accuracy in detecting early glaucoma. 6,7,8 Normative databases of RNFL thickness values from age-matched normals are used to interpret thickness measurements generated by SD-OCT machines.…”

The comparison of manual vs automated disc margin delineation using spectral-domain optical coherence tomography

“…A laser diode with 840±10 nm wavelength captures 26 000 A-scans/second, with a frame rate of 256-4096 A-scans/frame and 5 mm axial and 15 mm transverse resolution, and, similar to other SDOCT technologies, uses fast Fourier transformation of collected frequencies to improve the signal-to-noise ratio. [14][15][16][17] The ONH protocol was used to obtain both the ONH and RNFL measurements. RNFL thickness measurements were taken along 13 circular B-scans with diameters of 1.3-4.9 mm manually positioned on the optic disc to create a peripapillary RNFL thickness map.…”