title: The comparison of manual vs automated disc margin delineation using spectral-domain optical coherence tomography.
abstract: OBJECTIVE
  To examine the impact of manual vs automated disc margin delineation on optic nerve head (ONH) and retinal nerve fiber layer (RNFL) parameters using spectral-domain optical coherence tomography (SDOCT).
  
  
  METHODS
  A prospective cohort study consisting of normal, glaucoma suspect (GS) and glaucoma patients who underwent ONH and RNFL measurements using SDOCT technology (RTVue; Optovue Inc.). The retinal pigment epithelium/Bruch's membrane (RPE/BM) complex end points were automatically determined first, and were manually redefined subsequently. Analysis of variance, coefficient of variation (COV), concordance correlation coefficient (CCC), and Bland-Altman plots were used for the analyses.
  
  
  RESULTS
  Ninety-nine eyes of 50 subjects (age 68±10 years) consisting of 36 glaucoma, 56 GS, and 7 normal eyes were included. The RNFL thickness measurements were similar (P>0.05) between the two methods of demarcation, except for the inferior-nasal sector (P=0.04). For the ONH measurements, the cup-to-disc (C/D) ratio and rim area showed significant differences between the two methods (P<0.001). COV/CCC values for the ONH parameters were as follows: cup area 17.6%/0.88; cup volume 7.4%/0.91; average C/D ratio 18.1%/0.78; rim area 25.3%/0.69; and rim volume 42.6%/0.71, respectively. CCC/COV values for the RNFL parameters were as follows: average 2.1%/0.98; inferior-temporal quadrant 8.1%/0.79; inferior-nasal quadrant INQ quadrant 12.6%/0.67; SNQ quadrant 7.8%/0.83; and STQ quadrant 7.8%/0.88, respectively.
  
  
  CONCLUSIONS
  An overall high agreement and moderate-substantial concordance was observed between the demarcation methods. Automated disc margin delineation of SDOCT can be used reliably in clinical practice.
authors.affiliation: Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Palm Beach Gardens, FL, USA.
authors.forename: S M
authors.initials: SM
authors.lastname: Iverson
authors.forename: M
authors.initials: M
authors.lastname: Sehi
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D016022:Case-Control Studies; D003941:Diagnostic Techniques, Ophthalmological; D005260:Female; D005901:Glaucoma / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009412:Nerve Fibers / Q000473:pathology; D009898:Optic Disk / Q000473:pathology*; D011446:Prospective Studies; D041623:Tomography, Optical Coherence / Q000379:methods*
references.citation: Arch Ophthalmol. 2008 Jan;126(1):58-64
references.pmid: 18195219
references.citation: Ophthalmology. 1996 Nov;103(11):1889-98
references.pmid: 8942887
references.citation: J Glaucoma. 2011 Feb;20(2):80-6
references.pmid: 20436363
references.citation: Invest Ophthalmol Vis Sci. 2009 May;50(5):2165-74
references.pmid: 19136694
references.citation: J Glaucoma. 2012 Jan;21(1):49-54
references.pmid: 21952500
references.citation: Graefes Arch Clin Exp Ophthalmol. 2011 Jul;249(7):1039-45
references.pmid: 21240522
references.citation: Prog Retin Eye Res. 2008 Jan;27(1):45-88
references.pmid: 18036865
references.citation: J Glaucoma. 2010 Aug;19(6):412-7
references.pmid: 19855292
references.citation: J Glaucoma. 2012 Aug;21(6):367-71
references.pmid: 21522024
references.citation: J Glaucoma. 2008 Apr-May;17(3):183-8
references.pmid: 18414102
references.citation: J Glaucoma. 2012 Apr-May;21(4):214-20
references.pmid: 21654510
references.citation: J Glaucoma. 2000 Feb;9(1):56-62
references.pmid: 10708233
references.citation: Ophthalmic Surg Lasers Imaging. 2003 Nov-Dec;34(6):498-504
references.pmid: 14620759
references.citation: Am J Ophthalmol. 1989 May 15;107(5):453-64
references.pmid: 2712129
references.citation: Eye (Lond). 2006 Nov;20(11):1288-99
references.pmid: 16179933
references.citation: J Glaucoma. 2012 Apr-May;21(4):260-5
references.pmid: 21623226
references.citation: Am J Ophthalmol. 2003 Apr;135(4):504-12
references.pmid: 12654368
references.citation: Opt Express. 2009 Mar 2;17(5):4004-18
references.pmid: 19259242
references.citation: Invest Ophthalmol Vis Sci. 2009 Oct;50(10):4709-18
references.pmid: 19443718
references.citation: Ophthalmology. 2012 Apr;119(4):738-47
references.pmid: 22222150
references.citation: Invest Ophthalmol Vis Sci. 2012 Apr 18;53(4):1852-60
references.pmid: 22410561
references.citation: Invest Ophthalmol Vis Sci. 2008 Dec;49(12):5386-91
references.pmid: 18676630
references.citation: Am J Ophthalmol. 2009 Oct;148(4):597-605
references.pmid: 19589493
references.citation: Ophthalmology. 2011 Jul;118(7):1334-9
references.pmid: 21377735
references.citation: Lancet. 2004 May 22;363(9422):1711-20
references.pmid: 15158634
references.citation: Am J Ophthalmol. 2010 Jan;149(1):18-31
references.pmid: 20103039
references.citation: Ophthalmic Surg Lasers Imaging. 2011 Jul-Aug;42(4):328-37
references.pmid: 21800805
references.citation: Biometrics. 1989 Mar;45(1):255-68
references.pmid: 2720055
references.citation: Am J Ophthalmol. 2008 Apr;145(4):598-603
references.pmid: 18295183