Comparison of retinal nerve fiber layer thickness in normal eyes using time-domain and spectral-domain optical coherence tomography.
OBJECTIVE
To compare retinal nerve fiber layer (RNFL) thickness measurements between 3 different spectral-domain optical coherence tomography (SD-OCT) instruments (Spectralis; Heidelberg Engineering; Cirrus; Carl Zeiss Meditec; RTVue; Optovue, Inc) and one time-domain OCT (Stratus; Carl Zeiss Meditec).


METHODS
Prospective, cross-sectional study.


METHODS
RNFL thickness was measured on both eyes of 40 normal subjects using Stratus, Spectralis, RTVue, and Cirrus OCT on the same day. Scans were repeated 2 to 8 weeks later in the same fashion. Agreement with Stratus was evaluated for each SD-OCT and intervisit reproducibility was assessed for all machines.


RESULTS
Mean RNFL thickness determined by each of the 3 SD-OCT instruments was highly correlated with Stratus (r = 0.87-0.91). The mean RNFL thickness (mean ± standard deviation) was 110.1 ± 12.8 μm for Stratus, 106.6 ± 12.8 μm for Spectralis, 98.7 ± 10.9 μm for Cirrus, and 112.8 ± 13.2 μm for RTVue. The average differences between each SD-OCT and Stratus for mean RNFL thickness were all statistically significant (P ≤ .001), as were most quadrant measurements. All 4 instruments demonstrated excellent intraclass correlation coefficient values for mean RNFL thickness (0.90-0.97). However, intervisit variability was lowest for RTVue as evidenced by reproducibility values, followed by Stratus, Cirrus, and Spectralis (6.59, 8.83, 8.89, and 11.72 μm, respectively).


CONCLUSIONS
RNFL measurements taken with Spectralis, RTVue, and Cirrus all have excellent correlation to Stratus, with good reproducibility in normal eyes. Despite high correlations, RNFL values are significantly different between instruments and should not be used interchangeably.
Seibold
Leonard K
LK
Rocky Mountain Lions Eye Institute, Department of Ophthalmology, University of Colorado at Denver, Aurora, Colorado 80045, USA.
Mandava
Naresh
N
Kahook
Malik Y
MY
D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009412:Nerve Fibers; D009898:Optic Disk / Q000033:anatomy & histology*; D011446:Prospective Studies; D012016:Reference Values; D015203:Reproducibility of Results; D012165:Retinal Ganglion Cells / Q000166:cytology*; D041623:Tomography, Optical Coherence / Q000295:instrumentation*; D014792:Visual Acuity; D055815:Young Adult