Ji Hyun Kim1, Na Rae Kim1, Hyunjoong Kim2, Eun Suk Lee3, Gong Je Seong1, Chan Yun Kim1. 1. Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine, CPO Box 8044, Seoul, 120-752, Korea. 2. Department of Applied Statistics, Yonsei University, Seoul, Korea. 3. Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine, CPO Box 8044, Seoul, 120-752, Korea. eslee.korea@gmail.com.
Abstract
PURPOSE: To assess the effect of signal strength (SS) on the reproducibility of circumpapillary retinal nerve fiber layer (cpRNFL) thickness measurement (measurement agreement) and its color-coded classification (classification agreement) by Cirrus spectral-domain optical coherence tomography (OCT). METHODS: Seven hundred and eighty-nine participants, consecutively enrolled from December 2009 to August 2010, underwent two repeated Cirrus OCT scans to measure cpRNFL thickness (optic disc cube 200 × 200). Intraclass correlation (ICC) and linear-weighted kappa coefficient (κ) were calculated as indicators for cpRNFL measurement and classification agreement. The difference in cpRNFL thickness measurements between repeated OCT scans (inter-scan measurement difference) was correlated with mean SS, SS change or difference between repeated OCT scans (inter-scan SS difference), and average cpRNFL thickness. RESULTS: Mean SS was negatively correlated with inter-scan SS difference and was positively correlated with the inter-scan measurement difference. Repeated scans with SS change (inter-scan SS difference = 1 or 2) showed larger variability than scans without SS change (inter-scan SS difference = 0) in total average cpRNFL and all quadrant maps except for the nasal quadrant. Multivariate analysis revealed that inter-scan measurement differences increased in subjects with thinner cpRNFL thicknesses and in scans with lower mean SS and higher inter-scan SS differences. Measurement agreement (ICC) in groups with larger inter-scan SS differences (=2) was lower than those with smaller inter-scan SS differences (=0 or 1) in their average cpRNFL and inferior quadrant maps. Classification agreement (κ) in groups with larger inter-scan SS differences (=2) was lower than those with smaller inter-scan SS differences (=0 or 1) in their average cpRNFL and quadrant maps (superior and inferior quadrant) although statistically not significant. CONCLUSIONS: Special attention should be paid when comparing the cpRNFL thickness measurement and color-coded classification of 2 or more Cirrus OCT scans as the agreements may be susceptible to SS differences.
PURPOSE: To assess the effect of signal strength (SS) on the reproducibility of circumpapillary retinal nerve fiber layer (cpRNFL) thickness measurement (measurement agreement) and its color-coded classification (classification agreement) by Cirrus spectral-domain optical coherence tomography (OCT). METHODS: Seven hundred and eighty-nine participants, consecutively enrolled from December 2009 to August 2010, underwent two repeated Cirrus OCT scans to measure cpRNFL thickness (optic disc cube 200 × 200). Intraclass correlation (ICC) and linear-weighted kappa coefficient (κ) were calculated as indicators for cpRNFL measurement and classification agreement. The difference in cpRNFL thickness measurements between repeated OCT scans (inter-scan measurement difference) was correlated with mean SS, SS change or difference between repeated OCT scans (inter-scan SS difference), and average cpRNFL thickness. RESULTS: Mean SS was negatively correlated with inter-scan SS difference and was positively correlated with the inter-scan measurement difference. Repeated scans with SS change (inter-scan SS difference = 1 or 2) showed larger variability than scans without SS change (inter-scan SS difference = 0) in total average cpRNFL and all quadrant maps except for the nasal quadrant. Multivariate analysis revealed that inter-scan measurement differences increased in subjects with thinner cpRNFL thicknesses and in scans with lower mean SS and higher inter-scan SS differences. Measurement agreement (ICC) in groups with larger inter-scan SS differences (=2) was lower than those with smaller inter-scan SS differences (=0 or 1) in their average cpRNFL and inferior quadrant maps. Classification agreement (κ) in groups with larger inter-scan SS differences (=2) was lower than those with smaller inter-scan SS differences (=0 or 1) in their average cpRNFL and quadrant maps (superior and inferior quadrant) although statistically not significant. CONCLUSIONS: Special attention should be paid when comparing the cpRNFL thickness measurement and color-coded classification of 2 or more Cirrus OCT scans as the agreements may be susceptible to SS differences.
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