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      Comparison of Retinal Nerve Fiber Layer and Ganglion Cell–Inner Plexiform Layer Thickness Values Using Spectral-Domain and Swept-Source OCT

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          Abstract

          Purpose

          To compare peripapillary retinal nerve fiber layer (pRNFL) and macular ganglion cell–inner plexiform layer (mGCIPL) thickness measurements obtained with spectral domain optical coherence tomography (SD-OCT) and swept-source OCT (SS-OCT) using an OCT-angiography scanning protocol, and their ability to distinguish among patients with glaucoma, glaucoma suspects (GS), and healthy controls (HC).

          Methods

          Cross-sectional study of 196 eyes (81 glaucoma, 48 GS, and 67 HC) of 119 participants. Participants underwent peripapillary and macular OCT with SD-OCT and SS-OCT. Parameters of interest were average and sector-wise pRNFL and mGCIPL thickness. Inter-device agreement was investigated with Bland-Altman statistics. Conversion formulas were developed with linear regression. Diagnostic performances were evaluated with area under the receiver operating characteristic curves.

          Results

          Both SD-OCT and SS-OCT detected a significant pRNFL and mGCIPL thinning in glaucoma patients compared to HC and GS for almost all study sectors. A strong linear relationship between the two devices was present for all quadrants/sectors ( R 2 ≥ 0.81, P < 0.001), except for the nasal ( R 2 = 0.49, P < 0.001) and temporal ( R 2 = 0.62, P < 0.001) pRNFL quadrants. SD-OCT and SS-OCT measurements had a proportional bias, which could be removed with conversion formulas. Overall, the two devices showed similar diagnostic abilities.

          Conclusions

          Thickness values obtained with SD-OCT and SS-OCT are not directly interchangeable but potentially interconvertible. Both devices have a similar ability to discriminate glaucoma patients from GS and healthy subjects.

          Translational Relevance

          OCT-Angiography scans can be reliably used to obtain structural metrics in glaucoma patients.

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          Most cited references58

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          Adjusting for multiple testing--when and how?

          Ralf Bender, Stefan Lange (2001)
          Multiplicity of data, hypotheses, and analyses is a common problem in biomedical and epidemiological research. Multiple testing theory provides a framework for defining and controlling appropriate error rates in order to protect against wrong conclusions. However, the corresponding multiple test procedures are underutilized in biomedical and epidemiological research. In this article, the existing multiple test procedures are summarized for the most important multiplicity situations. It is emphasized that adjustments for multiple testing are required in confirmatory studies whenever results from multiple tests have to be combined in one final conclusion and decision. In case of multiple significance tests a note on the error rate that will be controlled for is desirable.
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            Determinants of normal retinal nerve fiber layer thickness measured by Stratus OCT.

            Donald L. Budenz, Jonathan Savell, S Greenfield … (2007)
            To determine the effects of age, optic disc area, ethnicity, eye, gender, and axial length on the retinal nerve fiber layer (RNFL) in the normal human eye as measured by Stratus OCT (optical coherence tomography). Cross-sectional observational study. Three hundred twenty-eight normal subjects 18 to 85 years old. Peripapillary Fast RNFL scans performed by Stratus OCT with a nominal diameter of 3.46 mm centered on the optic disc were performed on one randomly selected eye of each subject. Linear regression analysis of the effects of age, ethnicity, gender, eye, axial length, and optic disc area on peripapillary RNFL thickness. The mean RNFL thickness for the entire population was 100.1 microm (standard deviation, 11.6). Thinner RNFL measurements were associated with older age (P<0.001); being Caucasian, versus being either Hispanic or Asian (P = 0.006); greater axial length (P<0.001); or smaller optic disc area (P = 0.010). For every decade of increased age, mean RNFL thickness measured thinner by approximately 2.0 microm (95% confidence interval [CI], 1.2-2.8). For every 1-mm-greater axial length, mean RNFL thickness measured thinner by approximately 2.2 microm (95% CI, 1.1-3.4). For every increase in square millimeter of optic disc area, mean RNFL thickness increased by approximately 3.3 microm (95% CI, 0.6-5.6). Comparisons between ethnic groups revealed that Caucasians had mean RNFL values (98.1+/-10.9 microm) slightly thinner than those of Hispanics (103.7+/-11.6 microm; P = 0.022) or Asians (105.8+/-9.2 microm; P = 0.043). There was no relationship between RNFL thickness and eye or gender. Retinal nerve fiber layer thickness, as measured by Stratus OCT, varies significantly with age, ethnicity, axial length, and optic disc area. These variables may need to be taken into account when evaluating patients for diagnosis and follow-up of glaucoma, particularly at the lower boundary of the normal range. Due to the relatively small numbers of subjects of Asian and African descent in the normative database, conclusions regarding the effect of ethnicity should be interpreted with caution.
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              How to control confounding effects by statistical analysis

              Mohamad Pourhoseingholi, Ahmad Baghestani, Mohsen Vahedi (2012)
              A Confounder is a variable whose presence affects the variables being studied so that the results do not reflect the actual relationship. There are various ways to exclude or control confounding variables including Randomization, Restriction and Matching. But all these methods are applicable at the time of study design. When experimental designs are premature, impractical, or impossible, researchers must rely on statistical methods to adjust for potentially confounding effects. These Statistical models (especially regression models) are flexible to eliminate the effects of confounders.
              Article 0 comments Cited 141 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Transl Vis Sci Technol
                Journal ID (iso-abbrev): Transl Vis Sci Technol
                Journal ID (publisher-id): TVST
                Title: Translational Vision Science & Technology
                Publisher: The Association for Research in Vision and Ophthalmology
                ISSN (Electronic): 2164-2591
                Publication date (Electronic): 29 June 2022
                Publication date Collection: June 2022
                Volume: 11
                Issue: 6
                Electronic Location Identifier: 27
                Affiliations
                [1 ]Department of Ophthalmology, University Vita-Salute, IRCCS San Raffaele, Milan, Italy
                [2 ]Optometry and Visual Sciences, City, University of London, London, UK
                [3 ]Ophthalmology Department, Fatebenefratelli and Ophthalmic Hospital, ASST-Fatebenefratelli-Sacco, Milan, Italy
                Author notes
                Correspondence: Alessandro Rabiolo, Department of Ophthalmology, University Vita-Salute, IRCCS San Raffaele, Milan, Italy. e-mail: rabiolo.alessandro@ 123456gmail.com
                Article
                Publisher ID: TVST-21-4331
                DOI: 10.1167/tvst.11.6.27
                PMC ID: 9251790
                PubMed ID: 35767273
                SO-VID: 59865130-0906-4866-befd-4cb429260f5c
                Copyright © Copyright 2022 The Authors
                License:

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                Date accepted : 26 May 2022
                Date received : 05 December 2021
                Page count
                Pages: 15
                Categories
                Subject: Article
                Subject: Article

                Keywords: peripapillary retinal nerve fiber layer,macular ganglion cell-inner plexiform layer,glaucoma imaging,glaucoma diagnosis
                Data availability:
                Keywords: peripapillary retinal nerve fiber layer, macular ganglion cell-inner plexiform layer, glaucoma imaging, glaucoma diagnosis

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