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      Variance between Program Versions in Measuring Optic Nerve Fiber Layer Thickness Using Optical Coherence Tomography

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          Abstract

          Purpose: To compare nerve fiber layer thickness (NFLT) in patients with glaucoma measured by two versions of an analysis program utilizing optical coherence tomography (OCT) with reference to the cup-to-disk (C/D) ratio and the mean deviation (MD) score of a static visual field test. Methods: Twenty-four eyes from 24 glaucoma patients were enrolled. The NFLT was measured by OCT along a circle around the disk with the circle diameter being 1.5 times that of the disk itself. The NFLTs evaluated by the two versions A4.01 and A6.01 were compared with respect to the C/D ratio and MD score. Results: The mean NFLTs evaluated by version A6.01 were 61.2% greater than those evaluated by version A4.01 (p < 0.001). The NFLTs in all quadrants evaluated by A6.01 were also greater than those evaluated by A4.01. Both A6.01 and A4.01 showed a significant correlation with the C/D ratio and MD score. Although A6.01 showed a better correlation with the C/D ratio than A4.01, both A4.01 and A6.01 showed similarly good correlations with MD. Conclusion: The NFLTs evaluated by the two versions differed significantly with regard to some parameters. These results should be taken into account in evaluating NFLTs when utilizing OCT.

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          Most cited references 3

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          Heidelberg retina tomography and optical coherence tomography in normal, ocular-hypertensive, and glaucomatous eyes.

          To evaluate optic disc and retinal nerve fiber layer (RNFL) appearance in normal, ocular-hypertensive, and glaucomatous eyes undergoing confocal scanning laser ophthalmoscopy and optical coherence tomography (OCT). Prospective, cross-sectional study. Seventy-eight eyes of 78 consecutive normal (n = 17), ocular-hypertensive (n = 23), and glaucomatous subjects (n = 38) were enrolled. Each patient underwent complete ophthalmic examination, achromatic automated perimetry, confocal scanning laser ophthalmoscopy (Heidelberg Retinal Tomography [HRT]), and OCT. Topographic HRT parameters (disc area, cup-disc ratio, rim area, rim volume, cup shape measure, mean RNFL thickness, and cross-sectional area) and mean OCT-generated RNFL thickness were evaluated in each group. OCT and HRT assessment of optic disc and RNFL anatomy. OCT RNFL thickness showed no difference between normal and ocular-hypertensive eyes (P = 0.15) but was significantly less in glaucomatous eyes (P < 0.001). HRT measurements of rim area, cup-disc ratio, cup shape measure, RNFL thickness, and RNFL cross-sectional area were significantly less in glaucomatous eyes (all P < 0.005) and were correlated with mean OCT RNFL thickness (all P < 0.02). RNFL thickness using OCT or HRT was highly correlated with visual field mean defect during achromatic perimetry (P < 0.0001). Both HRT and OCT can differentiate glaucomatous from nonglaucomatous eyes. RNFL thickness measurements using OCT correspond to disc topographic parameters using HRT.
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            A comparison of optical coherence tomography and retinal nerve fiber layer photography for detection of nerve fiber layer damage in glaucoma.

             L Zangwill (2000)
            To compare optical coherence tomography (OCT) retinal nerve fiber layer (RNFL) thickness measurements with established methods for assessment of glaucomatous damage using RNFL photography and visual field testing. Cross-sectional study. Fifty-eight eyes of 58 healthy volunteer ocular hypertensive patients, glaucoma suspect patients, and glaucoma patients were included. Optical coherence tomography 3.4-mm diameter circular scans were obtained within 3 months of RNFL photography and standard achromatic visual field testing. Three independent observers graded RNFL photographs using two standardized protocols. For each method, superior and inferior arcuate bundles were scored separately, and interobserver and intraobserver variation was measured. Standard achromatic visual field mean deviation in the superior and inferior hemifields was compared with RNFL damage as assessed by photography and OCT RNFL thickness measurements. Visual field mean deviation and severity of glaucomatous RNFL damage as assessed by photography. Optical coherence tomography RNFL thickness decreased with increasing RNFL damage as assessed by photography using both methods of photographic assessment. Standard achromatic perimetry mean deviation was significantly associated with OCT RNFL thickness (R(2) = 35%-43%) and RNFL photography severity score (R(2) = 18%-29%). These results suggest that the OCT shows promise for providing quantitative measures of RNFL thickness for diagnosing and monitoring glaucoma.
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              • Article: found

              Reproducibility of Nerve Fiber Layer Thickness Measurements Using Optical Coherence Tomography in Silicone Oil-Filled Eyes

              Purpose: To evaluate the reproducibility of nerve fiber layer (NFL) thickness measurements by optical coherence tomography (OCT) in individuals with silicone oil-filled eyes. Methods: Eighteen patients who had undergone pars plana vitrectomy and silicone oil tamponade for retinal detachment were enrolled in a prospective, case-controlled clinical study. Each patient underwent OCT measurement of NFL thickness. Five repetitions of a series of scans on five separate occasions within a 0.5-month period were performed. Each eye was scanned at two different nerve head programs [radius (R) = 1.5 and R = 1.73]. The contralateral healthy eye was used as control. For each option (R = 1.5 and R = 1.73) and region (superior, inferior, temporal, nasal and overall mean), variance components and intraclass correlation coefficients (ICCs) were determined using repeated-measures regression. In these models, NFL thickness, as measured by OCT, was considered to have three variance components: intersubject, intervisit (within subject, between dates), and intravisit (within subject, within date). The ICC (intersubject variance/total variance) was used as a measure of reliability. Results: The contralateral healthy eye provided a higher degree of reproducibility than the silicone oil-filled eye (p = 0.0001). Reproducibility was higher in a given eye on a given visit than from visit to visit. Reproducibility as measured by ICCs was as follows: R = 1.5, 0.54/0.30 (control eyes/silicone oil-filled eyes); R = 1.73, 0.51/0.30. Conclusions: Reproducibility results for OCT measurement of NFL thickness are different in healthy eyes and silicone oil-filled eyes. NFL thickness measurement is not reliable in silicone oil-filled eyes.
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                Author and article information

                Journal
                OPH
                Ophthalmologica
                10.1159/issn.0030-3755
                Ophthalmologica
                S. Karger AG
                0030-3755
                1423-0267
                2002
                December 2002
                10 January 2003
                : 216
                : 6
                : 409-414
                Affiliations
                Department of Ophthalmology, Yamanashi Medical University, Yamanashi, Japan
                Article
                67543 Ophthalmologica 2002;216:409–414
                10.1159/000067543
                12566883
                © 2002 S. Karger AG, Basel

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                Page count
                Figures: 5, Tables: 2, References: 11, Pages: 6
                Categories
                Original Paper · Travail original · Originalarbeit

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