title: Optical coherence tomography-based decision making in exudative age-related macular degeneration: comparison of time- vs spectral-domain devices.
abstract: OBJECTIVE
  To determine whether optical coherence tomography (OCT) device-type influences clinical grading of OCT imaging in the context of exudative age-related macular degeneration (AMD).
  
  
  METHODS
  Ninety-six paired OCT scans from 49 patients with active exudative AMD were obtained on both the time-domain Stratus OCT system and the spectral-domain Cirrus OCT system at the same visit. Three independent graders judged each scan for the presence of intraretinal fluid (IRF) or subretinal fluid (SRF). The degree of grader consensus was evaluated and the ability of the systems to detect the presence of disease activity was analysed.
  
  
  RESULTS
  Cirrus OCT generated a higher degree of inter-grader consensus than Stratus OCT with higher intraclass correlation coefficients for all parameters analysed. A pair-wise comparison of Cirrus OCT with Stratus OCT systems revealed that Cirrus-based gradings more frequently reported the presence of SRF and IRF and detected overall neovascular activity at a higher rate (P<0.05) compared with Stratus-based gradings.
  
  
  CONCLUSIONS
  The choice of time-domain (Stratus) vs spectra-domain (Cirrus) OCT systems has a measurable impact on clinical decision making in exudative AMD. Spectral-domain OCT systems may be able to generate more consensus in clinical interpretation and, in particular cases, detect disease activity not detected by time-domain systems. Clinical trials using OCT-based clinical evaluations of exudative AMD may need to account for these inter-system differences in planning and analysis.
authors.affiliation: Division of Epidemiology and Clinical Research, National Eye Institute, National Institutes of Health, Bethesda, MD 20892, USA.
authors.forename: C
authors.initials: C
authors.lastname: Cukras
authors.forename: Y D
authors.initials: YD
authors.lastname: Wang
authors.forename: C B
authors.initials: CB
authors.lastname: Meyerle
authors.forename: F
authors.initials: F
authors.lastname: Forooghian
authors.forename: E Y
authors.initials: EY
authors.lastname: Chew
authors.forename: W T
authors.initials: WT
authors.lastname: Wong
mesh_terms: D003657:Decision Making; D005122:Exudates and Transudates; D006801:Humans; D008268:Macular Degeneration / Q000175:diagnosis*; D009389:Neovascularization, Pathologic / Q000473:pathology; D012160:Retina / Q000473:pathology; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence / Q000295:instrumentation / Q000379:methods*
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