Analysis of Agreement of Retinal-Layer Thickness Measures Derived from the Segmentation of Horizontal and Vertical Spectralis OCT Macular Scans

Natalia Gonzalez Caldito, Bhavna Antony, Yufan He, Andrew Lang, James Nguyen, Alissa Rothman, Esther Ogbuokiri, Ama Avornu, Laura Balcer, Elliot Frohman, Teresa C. Frohman, Pavan Bhargava, Jerry Ladd Prince, Peter Calabresi, Shiv Saidha

Research output: Contribution to journalArticle

Abstract

Purpose: Optical coherence tomography (OCT) is a reliable method used to quantify discrete layers of the retina. Spectralis OCT is a device used for this purpose. Spectralis OCT macular scan imaging acquisition can be obtained on either the horizontal or vertical plane. The vertical protocol has been proposed as favorable, due to postulated reduction in confound of Henle’s fibers on segmentation-derived metrics. Yet, agreement of the segmentation measures of horizontal and vertical macular scans remains unexplored. Our aim was to determine this agreement. Materials and methods: Horizontal and vertical macular scans on Spectralis OCT were acquired in 20 healthy controls (HCs) and 20 multiple sclerosis (MS) patients. All scans were segmented using Heidelberg software and a Johns Hopkins University (JHU)-developed method. Agreement was analyzed using Bland–Altman analyses and intra-class correlation coefficients (ICCs). Results: Using both segmentation techniques, mean differences (agreement at the cohort level) in the thicknesses of all macular layers derived from both acquisition protocols in MS patients and HCs were narrow (<1 µm), while the limits of agreement (LOA) (agreement at the individual level) were wider. Using JHU segmentation mean differences (and LOA) for the macular retinal nerve fiber layer (RNFL) and ganglion cell layer + inner plexiform layer (GCIP) in MS were 0.21 µm (−1.57–1.99 µm) and −0.36 µm (−1.44–1.37 µm), respectively. Conclusions: OCT segmentation measures of discrete retinal-layer thicknesses derived from both vertical and horizontal protocols on Spectralis OCT agree excellently at the cohort level (narrow mean differences), but only moderately at the individual level (wide LOA). This suggests patients scanned using either protocol should continue to be scanned with the same protocol. However, due to excellent agreement at the cohort level, measures derived from both acquisitions can be pooled for outcome purposes in clinical trials.

Original languageEnglish (US)
Pages (from-to)1-9
Number of pages9
JournalCurrent Eye Research
DOIs
StateAccepted/In press - Dec 15 2017

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Retinaldehyde
Optical Coherence Tomography
Multiple Sclerosis
Nerve Fibers
Ganglia
Retina
Software
Clinical Trials
Equipment and Supplies

Keywords

  • analysis of agreement
  • multiple sclerosis (MS)
  • Optical coherence tomography (OCT)
  • retinal layers
  • segmentation

ASJC Scopus subject areas

  • Ophthalmology
  • Sensory Systems
  • Cellular and Molecular Neuroscience

Cite this

Analysis of Agreement of Retinal-Layer Thickness Measures Derived from the Segmentation of Horizontal and Vertical Spectralis OCT Macular Scans. / Gonzalez Caldito, Natalia; Antony, Bhavna; He, Yufan; Lang, Andrew; Nguyen, James; Rothman, Alissa; Ogbuokiri, Esther; Avornu, Ama; Balcer, Laura; Frohman, Elliot; Frohman, Teresa C.; Bhargava, Pavan; Prince, Jerry Ladd; Calabresi, Peter; Saidha, Shiv.

In: Current Eye Research, 15.12.2017, p. 1-9.

Research output: Contribution to journalArticle

Gonzalez Caldito, Natalia ; Antony, Bhavna ; He, Yufan ; Lang, Andrew ; Nguyen, James ; Rothman, Alissa ; Ogbuokiri, Esther ; Avornu, Ama ; Balcer, Laura ; Frohman, Elliot ; Frohman, Teresa C. ; Bhargava, Pavan ; Prince, Jerry Ladd ; Calabresi, Peter ; Saidha, Shiv. / Analysis of Agreement of Retinal-Layer Thickness Measures Derived from the Segmentation of Horizontal and Vertical Spectralis OCT Macular Scans. In: Current Eye Research. 2017 ; pp. 1-9.
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abstract = "Purpose: Optical coherence tomography (OCT) is a reliable method used to quantify discrete layers of the retina. Spectralis OCT is a device used for this purpose. Spectralis OCT macular scan imaging acquisition can be obtained on either the horizontal or vertical plane. The vertical protocol has been proposed as favorable, due to postulated reduction in confound of Henle’s fibers on segmentation-derived metrics. Yet, agreement of the segmentation measures of horizontal and vertical macular scans remains unexplored. Our aim was to determine this agreement. Materials and methods: Horizontal and vertical macular scans on Spectralis OCT were acquired in 20 healthy controls (HCs) and 20 multiple sclerosis (MS) patients. All scans were segmented using Heidelberg software and a Johns Hopkins University (JHU)-developed method. Agreement was analyzed using Bland–Altman analyses and intra-class correlation coefficients (ICCs). Results: Using both segmentation techniques, mean differences (agreement at the cohort level) in the thicknesses of all macular layers derived from both acquisition protocols in MS patients and HCs were narrow (<1 µm), while the limits of agreement (LOA) (agreement at the individual level) were wider. Using JHU segmentation mean differences (and LOA) for the macular retinal nerve fiber layer (RNFL) and ganglion cell layer + inner plexiform layer (GCIP) in MS were 0.21 µm (−1.57–1.99 µm) and −0.36 µm (−1.44–1.37 µm), respectively. Conclusions: OCT segmentation measures of discrete retinal-layer thicknesses derived from both vertical and horizontal protocols on Spectralis OCT agree excellently at the cohort level (narrow mean differences), but only moderately at the individual level (wide LOA). This suggests patients scanned using either protocol should continue to be scanned with the same protocol. However, due to excellent agreement at the cohort level, measures derived from both acquisitions can be pooled for outcome purposes in clinical trials.",
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T1 - Analysis of Agreement of Retinal-Layer Thickness Measures Derived from the Segmentation of Horizontal and Vertical Spectralis OCT Macular Scans

AU - Gonzalez Caldito, Natalia

AU - Antony, Bhavna

AU - He, Yufan

AU - Lang, Andrew

AU - Nguyen, James

AU - Rothman, Alissa

AU - Ogbuokiri, Esther

AU - Avornu, Ama

AU - Balcer, Laura

AU - Frohman, Elliot

AU - Frohman, Teresa C.

AU - Bhargava, Pavan

AU - Prince, Jerry Ladd

AU - Calabresi, Peter

AU - Saidha, Shiv

PY - 2017/12/15

Y1 - 2017/12/15

N2 - Purpose: Optical coherence tomography (OCT) is a reliable method used to quantify discrete layers of the retina. Spectralis OCT is a device used for this purpose. Spectralis OCT macular scan imaging acquisition can be obtained on either the horizontal or vertical plane. The vertical protocol has been proposed as favorable, due to postulated reduction in confound of Henle’s fibers on segmentation-derived metrics. Yet, agreement of the segmentation measures of horizontal and vertical macular scans remains unexplored. Our aim was to determine this agreement. Materials and methods: Horizontal and vertical macular scans on Spectralis OCT were acquired in 20 healthy controls (HCs) and 20 multiple sclerosis (MS) patients. All scans were segmented using Heidelberg software and a Johns Hopkins University (JHU)-developed method. Agreement was analyzed using Bland–Altman analyses and intra-class correlation coefficients (ICCs). Results: Using both segmentation techniques, mean differences (agreement at the cohort level) in the thicknesses of all macular layers derived from both acquisition protocols in MS patients and HCs were narrow (<1 µm), while the limits of agreement (LOA) (agreement at the individual level) were wider. Using JHU segmentation mean differences (and LOA) for the macular retinal nerve fiber layer (RNFL) and ganglion cell layer + inner plexiform layer (GCIP) in MS were 0.21 µm (−1.57–1.99 µm) and −0.36 µm (−1.44–1.37 µm), respectively. Conclusions: OCT segmentation measures of discrete retinal-layer thicknesses derived from both vertical and horizontal protocols on Spectralis OCT agree excellently at the cohort level (narrow mean differences), but only moderately at the individual level (wide LOA). This suggests patients scanned using either protocol should continue to be scanned with the same protocol. However, due to excellent agreement at the cohort level, measures derived from both acquisitions can be pooled for outcome purposes in clinical trials.

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