title: Comparison of foveal microstructure imaging with different spectral domain optical coherence tomography machines.
abstract: OBJECTIVE
  To investigate the reproducibility of imaging the foveal microstructures of healthy eyes with 3 spectral domain optical coherence tomography (SD-OCT) machines: Cirrus (Carl Zeiss Meditec Inc.), Spectralis (Heidelberg Engineering), and Topcon (Topcon 3D OCT-1000 Mark II).
  
  
  METHODS
  Cross-sectional, prospective, noninterventional study.
  
  
  METHODS
  Images were obtained for 50 eyes of 50 healthy undilated volunteers without ocular pathology in a clinical setting.
  
  
  METHODS
  The fovea of all subjects was imaged using Cirrus, Spectralis, and Topcon.
  
  
  METHODS
  Among the 4 hyperreflective bands in the outer subfovea on SD-OCT imaging, the innermost band (external limiting membrane [ELM] band), the second innermost band (second band), and the third innermost band (third band) were classified as "continuous," "disrupted," or "none" by 2 independent raters. Weighted κ-coefficient analysis and/or Fisher exact test were used to compare interrater, intermachine, and intramachine agreement measurements. The sensitivity of each machine was also evaluated.
  
  
  RESULTS
  The group of 50 subjects consisted of 22 men and 28 women, with an average age of 31.4 years (range, 21-52 years). Interrater agreement for 3 bands was high (κ = 0.876, 0.738, and 0.774) with Cirrus, Spectralis, and Topcon, respectively. The sensitivity of each machine was high for the ELM band (0.92, 0.98, and 0.96), the second band (all 1.00), and the third band (0.96, 0.94, and 0.88) with Cirrus, Spectralis, and Topcon, respectively. The sensitivity of the third band was significantly lower than the second band with Topcon (Fisher exact test, P = 0.027), but the difference was not significant with the other machines. Intermachine agreement was fair to moderate for the third band (κ = 0.65, 0.512, and 0.464) and for all bands (κ = 0.531, 0.369, and 0.362) between Cirrus-Spectralis, Spectralis-Topcon, and Topcon-Cirrus, respectively; however, it was not significant for ELM band (κ = -0.027) between Spectralis-Topcon.
  
  
  CONCLUSIONS
  In healthy adults with normal vision, there was almost perfect reproducibility between raters for foveal microstructural images acquired with the Cirrus, Spectralis, and Topcon devices. The machines have good sensitivity to image foveal microstructures, and the sensitivity does not differ significantly among machines; however, they are not necessarily identical or interchangeable for imaging certain structures.
authors.affiliation: Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
authors.forename: Hiroto
authors.initials: H
authors.lastname: Terasaki
authors.forename: Makoto
authors.initials: M
authors.lastname: Shirasawa
authors.forename: Takehiro
authors.initials: T
authors.lastname: Yamashita
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Yamashita
authors.forename: Keita
authors.initials: K
authors.lastname: Yamakiri
authors.forename: Shozo
authors.initials: S
authors.lastname: Sonoda
authors.forename: Taiji
authors.initials: T
authors.lastname: Sakamoto
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005189:False Positive Reactions; D005260:Female; D005584:Fovea Centralis / Q000033:anatomy & histology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D041623:Tomography, Optical Coherence / Q000295:instrumentation* / Q000592:standards; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult