Digital imaging of the optic nerve head: monoscopic and stereoscopic analysis.
OBJECTIVE
To compare monoscopic and stereoscopic assessment of the optic disc using novel software for the digital stereoscopic analysis of optic disc stereopairs.


METHODS
Software was developed for the stereoscopic display of digital optic disc images using an interlaced display method. Neuroretinal rim width was determined at 10 degree intervals around the optic disc using a custom (stereoscopic) cursor whose depth was adjusted to that of Elschnig's rim. Measurements were taken, first viewing the disc monoscopically and at a separate sitting, stereoscopically.


RESULTS
Measurements were made in 35 eyes from 35 patients (1260 estimates for each observer) using three observers. The mean cup to disc ratio (CDR) ranged from 0.57 to 0.66 (SD 0.13-0.14) for monoscopic viewing compared with 0.64 to 0.69 (SD 0.12-0.14) for stereoscopic viewing. Stereoscopic assessments gave higher CDRs in temporal, superior, nasal, and inferior aspects of the optic disc (p<0.001, Mann-Whitney U test). Agreement between observers in estimating CDR was high for monoscopic assessment (intraclass correlation coefficient 0.74 (CI 0.72 to 0.76) increasing to 0.80 (0.78 to 0.82) for stereoscopic assessment.


CONCLUSIONS
Digital stereoscopic optic disc assessment provides lower estimates of neuroretinal rim width and higher levels of interobserver agreement compared with monoscopic assessments.
Morgan
J E
JE
Department of Ophthalmology, University Hospital of Wales, Heath Park, Cardiff CF4 4XW, UK. morganje3@cardiff.ac.uk
Sheen
N J L
NJ
North
R V
RV
Choong
Y
Y
Ansari
E
E
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005901:Glaucoma / Q000473:pathology*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008875:Middle Aged; D015588:Observer Variation; D009898:Optic Disk / Q000473:pathology*; D010781:Photography / Q000379:methods; D012984:Software