Korean J Ophthalmol.  2014 Apr;28(2):138-149. 10.3341/kjo.2014.28.2.138.

Reproducibility of Peripapillary Retinal Nerve Fiber Layer Thickness Measured by Spectral Domain Optical Coherence Tomography in Pseudophakic Eyes

• Kim GA
• Kim JH
• Lee JM
• Park KS

• KMID: 1792107
• DOI: http://doi.org/10.3341/kjo.2014.28.2.138

Abstract

PURPOSE
To assess the reproducibility of circumpapillary retinal nerve fiber layer (cpRNFL) thickness measurement (measurement agreement) and its color-coded classification (classification agreement) by Cirrus spectral domain optical coherence tomography (OCT) in pseudophakic eyes.
METHODS
Two-hundred five participants having glaucoma or glaucoma suspected eyes underwent two repeated Cirrus OCT scans to measure cpRNFL thickness (optic disc cube 200 x 200). After classifying participants into three different groups according to their lens status (clear media, cataract, and pseudophakic), values of intra-class coefficient (ICC), coefficient of variance, and test-retest variability were compared between groups for average retinal nerve fiber layer (RNFL) thicknesses and that corresponding to four quadrant maps. Linear weighted kappa coefficients were calculated as indicators of agreement of color code classification in each group.
RESULTS
ICC values were all excellent (generally defined as 0.75 to 1.00) for the average and quadrant RNFL thicknesses in all three groups. ICC values of the clear media group tended to be higher than those in the cataract and pseudophakic groups for all quadrants and average thickness. Especially in the superior and nasal quadrants, the ICC value of the cataract group was significantly lower than that of the clear media and pseudophakic groups. For average RNFL thickness, classification agreement (kappa) in three groups did not show a statistically significant difference. For quadrant maps, classification agreement (kappa) in the clear media group was higher than those in the other two groups.
CONCLUSIONS
Agreement of cpRNFL measurement and its color code classification between two repeated Cirrus OCT scans in pseudophakic eyes was as good as that in eyes with clear crystalline lens. More studies are required to ascertain the effect of lens status on the reproducibility of Cirrus OCT according to different stages of glaucoma patients.

Keyword

Optical coherence tomography; Pseudophakia; Reproducibility of results

MeSH Terms

Aged
Cataract/complications
Cataract Extraction
Female
Glaucoma/complications/*pathology
Humans
Lens, Crystalline/cytology/pathology
Male
Middle Aged
Nerve Fibers/pathology
Optic Disk/pathology
Pseudophakia/complications
Reproducibility of Results
Retinal Ganglion Cells/*pathology
Tomography, Optical Coherence/*methods/*standards

Figure

• 

  Fig. 1 Bland-Altman plot analysis of the average retinal nerve fiber layer (RNFL) thickness measured by two repeated Cirrus optical coherence tomography scans. Note the greater variation between two repeated average RNFL thickness measurements in the cataract group than in the other groups. (A) Clear media. (B) Cataract. (C) Pseudophakic. STD = standard deviation.

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