Repeatability and Reproducibility of Manual Choroidal Volume Measurements Using Enhanced Depth Imaging Optical Coherence Tomography

Chhablani, Jay; Barteselli, Giulio; Wang, Haiyan; El-Emam, Sharif; Kozák, Igor; Doede, Aubrey L.; Bartsch, Dirk-Uwe; Cheng, Lingyun; Freeman, William R.

doi:10.1167/iovs.12-9435

Cited by 108 publications

(81 citation statements)

References 26 publications

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“…The Bland-Altman test and CCC are used to assess reproducibility. Bland-Altman consistency tests are used to assess the clinically relevant magnitude of differences between interobserver measurements [20] . In the plots shown in Figure 2 , the horizontal axis represents the averages of each eye's FAZ area measurements performed by the 2 observers, while the vertical axis represents the differences.…”

Section: Discussionmentioning

confidence: 99%

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Repeatability and Reproducibility of Foveal Avascular Zone Area Measurements Using AngioPlex Spectral Domain Optical Coherence Tomography Angiography in Healthy Subjects

Guo

She²,

Li³

et al. 2017

Ophthalmologica

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Purpose: The aim of this study was to evaluate the repeatability and reproducibility of foveal avascular zone (FAZ) area measurements using AngioPlex spectral domain optical coherence tomography (OCT) angiography in normal subjects. Methods: Twenty-two healthy subjects (25 eyes) underwent FAZ area measurements with AngioPlex OCT. Each volunteer was separately examined 3 consecutive times by the 2 experienced observers. The FAZ area was measured using ImageJ software. Intraobserver repeatability was evaluated by calculating the coefficient of variation (CoV) and intraclass correlation coefficient (ICC). Interobserver reproducibility was also assessed using the Bland-Altman test and concordance correlation coefficient (CCC). Results: The FAZ areas were measured as 0.373 ± 0.109 and 0.377 ± 0.112 mm² by observers 1 and 2, respectively. The repeatability assessment of the FAZ area measurements yielded CoV values of 0.029 and 0.034 and ICC values of 0.997 and 0.996 by observers 1 and 2, respectively. The mean difference between the 2 observers was 0.004. CCC values ranged from 0.9705 to 0.9844. Conclusions: The FAZ area measurements obtained using AngioPlex OCT showed a good repeatability and reproducibility in healthy subjects. Excellent reliability makes AngioPlex OCT a valid device for measuring the FAZ area.

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Section: Discussionmentioning

confidence: 99%

“…The CCC of the FAZ area measurements between observers 1 and 2 was measured to evaluate the agreement between them [15,16,20] . This parameter evaluates the degree to which pairs of measurements fall on a line with a 45° slope through the origin ( Fig.…”

Section: Discussionmentioning

confidence: 99%

Repeatability and Reproducibility of Foveal Avascular Zone Area Measurements Using AngioPlex Spectral Domain Optical Coherence Tomography Angiography in Healthy Subjects

Guo

She²,

Li³

et al. 2017

Ophthalmologica

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“…The internal limiting membrane layer was moved to the outer part of the RPE level and the Bruch membrane segmentation line was moved to the division between the choroid and the sclera. Moving both segmentation lines limits the choroid, and the values that appeared in the described macular areas were the true choroidal thickness values 17 . Segmentation was performed by the same observer, and one of the three choroidal maps was also segmented by another observer to ensure interobserver reproducibility.…”

Section: Methodsmentioning

confidence: 99%

Choroidal Thickness and Volume in Healthy Young White Adults and the Relationships between them and Axial Length, Ammetropy and Sex

Sánchez‐Cano

Orduna

Segura

et al. 2014

American Journal of Ophthalmology

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PURPOSE:To evaluate choroidal thickness in young subjects using Enhanced Depth Imaging Spectral Domain Optical Coherence Tomography (EDI SD-OCT) describing volume differences between all the defined areas of the Early Treatment Diabetic Retinopathy Study (ETDRS). DESIGN:Prospective, clinical study. METHODS:Seventy-nine eyes of 95 healthy, young (23.8±3.2years), adult volunteers were prospectively enrolled. Manual choroidal segmentation on a 25-raster horizontal scan protocol was performed. The measurements of the nine subfields defined by the ETDRS were evaluated. RESULTS:Mean subfoveal choroidal thickness was 345.67±81.80µm and mean total choroidal volume was 8.99±1.88mm 3 . Choroidal thickness and volume were higher at the superior and temporal areas compared to inferior and nasal sectors of the same diameter respectively. Strong correlations between subfoveal choroidal thickness and axial length (AL) and myopic refractive error were obtained, r = -0.649, p<0.001 and r = 0.473, p<0.001 respectively. Emmetropic eyes tended to have thicker subfoveal choroidal thickness (381.94±79.88µm versus 307.04±64.91µm) and higher total choroidal volume than myopic eyes (9.80± 1.87mm3 versus 8.14±1.48mm3). The estimation of the variation of the subfoveal choroidal thickness with the AL was -43.84µm/mm. In the myopic group, the variation of the subfoveal choroidal thickness with the myopic refractive error was -10.45µm/D. CONCLUSIONS:This study establishes for the first time a normal database for choroidal thickness and volume in young adults. Axial length, and myopic ammetropy are highly associated with choroidal parameters in healthy subjects. EDI SD-OCT exhibited a high degree of intraobserver and interobserver repeatability. M A N U S C R I P T A C C E P T E D ACCEPTED MANUSCRIPT INTRODUCTIONThe development of optical coherence tomography (OCT) technology has revolutionized the diagnostic, monitoring and therapeutic approaches to many retinal diseases. Spectral domain OCT (SD-OCT) offers improved axial resolution (3 µm); by providing 19,000 A-scans per second, it shortens examination times, reducing the eye exposure as well as artifacts 1 . The latest development in OCT technology, sweptsource longer-wavelength OCT (SS-OCT), has a longer-band light source than does the conventional instrumentation (1 µm band light source), providing higher penetration through the retinal pigment epithelium (RPE) and allowing for better visualization of the choroid; however, at the present time, SS-OCT use is limited to research.The role of the choroid in a number of diseases, including central serous chorioretinopathy, high myopia, age-related macular degeneration, choroidal melanoma, and polypoidal choroidal vasculopathy, emphasizes the importance of understanding choroidal structure in ocular disease [2][3][4][5] . Indocyanine green has been the best tool for studying choroidal vasculature; however, it does not provide a quantitative evaluation of the layer; other imaging methods such as echography aid in evaluating the layer, and MRI ...

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“…The internal limiting membrane layer was moved to the outer part of the RPE level, and the Bruch membrane segmentation line was moved to the division between the choroid and the sclera. Moving both segmentation lines limits the choroid, and the values that appeared in the described macular areas were the true CT values [17]. Segmentation was performed by the same observer.…”

Section: Methodsmentioning

confidence: 99%

Interocular Symmetry of Choroidal Thickness and Volume in Healthy Eyes on Optical Coherence Tomography

Orduna

Sánchez‐Cano²,

Luesma³

et al. 2017

Ophthalmic Res

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Background: We aimed to determine the physiological symmetry, with spectral-domain optical coherence tomography, of choroidal measurements in a healthy population in all the areas defined in the Early Treatment Diabetic Retinopathy Study (ETDRS). Methods: One hundred and fifty-four eyes of 77 healthy young adults between the ages of 19 and 32 years were enrolled. Differences in choroidal thickness (CT) and volume (CV) between the left and right eyes were calculated. Normal ranges of absolute interocular differences were established as the 95th percentile. Results: The mean ± SD subfoveal CT (SFCT) and total CV values in the right and left eyes were 342.03 ± 77.38 versus 361.64 ± 76.45 µm (correlation coefficient ρ = 0.820; p < 0.001) and 0.27 ± 0.06 versus 0.28 ± 0.06 mm³ (ρ = 0.830; p < 0.001), respectively. Differences in 5 of the 9 areas of the ETDRS map were statistically significant (p < 0.05), but with a strong interocular correlation (ρ > 0.8; p < 0.001). The 95th percentile of interocular tolerance limits for CT in the 1-, 3-, and 6-mm areas were 97, 70, and 57 μm, respectively; the 95th percentile for the volume values were 0.06, 0.51, and 1.73 mm³. Conclusions: CT and CV are highly correlated between eyes, statistically significant differences between them can be found, and absolute interocular differences may reach 97 µm in SFCT, and 1.73 mm³ in total CV.

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Repeatability and Reproducibility of Manual Choroidal Volume Measurements Using Enhanced Depth Imaging Optical Coherence Tomography

Abstract: CV measurement by manual segmentation using built-in automated retinal segmentation software on EDI-SD-OCT is highly reproducible and repeatable and has a very small range of variability.

Cited by 108 publications

References 26 publications

Repeatability and Reproducibility of Foveal Avascular Zone Area Measurements Using AngioPlex Spectral Domain Optical Coherence Tomography Angiography in Healthy Subjects

Repeatability and Reproducibility of Foveal Avascular Zone Area Measurements Using AngioPlex Spectral Domain Optical Coherence Tomography Angiography in Healthy Subjects

Choroidal Thickness and Volume in Healthy Young White Adults and the Relationships between them and Axial Length, Ammetropy and Sex

Interocular Symmetry of Choroidal Thickness and Volume in Healthy Eyes on Optical Coherence Tomography

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