title: Automatic, operator-adjusted, and manual disc-definition for optic nerve head and retinal nerve fiber layer measurements with the RTVue-100 optical coherence tomograph.
abstract: OBJECTIVE
  To evaluate the repeatability and between-methods differences of optic nerve head and retinal nerve fiber layer thickness (RNFLT) measurements as made with the automatic, operator-adjusted, and manual disc-definition functions of the RTVue-100 Fourier-domain optical coherence tomograph.
  
  
  METHODS
  One eye of each of 126 persons (72 glaucomatous, 10 ocular hypertensive, 44 healthy control eyes) was analyzed with all 3 disc-definition functions. Thirty-three eyes were imaged 5 times for the determination of measurement repeatability.
  
  
  RESULTS
  For several parameters, repeatability with automatic disc definition was significantly poorer than the other options. In contrast, for all but 1 parameter repeatability did not differ between the manual and operator-adjusted methods. Refractive error, disease category or peripapillary atrophy had no influence on repeatability. However, the measured values differed significantly between the methods, for all but 3 parameters. Similar between-method differences were seen for eyes irrespective of glaucoma, refractive error, or parapapillary atrophy. High intraclass correlation (93.5% to 99.9%) was seen for all parameters measured with manual and operator-adjusted methods, but in the other comparisons only for RNFLT parameters. Agreement of the classifications was better for RNFLT parameters than disc parameters, and the κ-values were highest (0.881 to 0.968) in comparing the manual and operator-adjusted methods.
  
  
  CONCLUSIONS
  Measurement repeatability with manual and operator-adjusted disc-definition functions is similar and is not influenced by refractive error, glaucoma, or parapapillary atrophy. The high intraclass correlation and the agreement of diagnostic classifications suggest that operator-adjusted disc-definition can be useful for glaucoma detection with the RTVue-100 Fourier-domain optical coherence tomograph.
authors.affiliation: Department of Ophthalmology, Semmelweis University, Budapest, Hungary.
authors.forename: Anita
authors.initials: A
authors.lastname: Garas
authors.forename: Pèter
authors.initials: P
authors.lastname: Vargha
authors.forename: Gábor
authors.initials: G
authors.lastname: Holló
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003941:Diagnostic Techniques, Ophthalmological / Q000295:instrumentation*; D005260:Female; D005583:Fourier Analysis; D005901:Glaucoma / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009412:Nerve Fibers / Q000473:pathology*; D009798:Ocular Hypertension / Q000175:diagnosis; D009898:Optic Disk / Q000473:pathology*; D015203:Reproducibility of Results; D012165:Retinal Ganglion Cells / Q000473:pathology*; D041623:Tomography, Optical Coherence / Q000295:instrumentation*