Evaluation of Retinal and Choroidal Thickness by Swept-Source Optical Coherence Tomography: Repeatability and Assessment of Artifacts

• Published in: American journal of ophthalmology 2014-05, Vol.157 (5), p.1022-1032.e3
• Main Authors: Mansouri, Kaweh, Medeiros, Felipe A, Tatham, Andrew J, Marchase, Nicholas, Weinreb, Robert N
• Format: Article
• Language: English
• Subjects: Adult; Anatomy & physiology; Automation; Choroid - anatomy & histology; Colleges & universities; Confidence intervals; Female; Health Insurance Portability & Accountability Act 1996-US; Healthy Volunteers; Humans; Macular degeneration; Male; Measurement techniques; Middle Aged; Ophthalmology; Optics; Organ Size; Prospective Studies; Reproducibility of Results; Retina; Retina - anatomy & histology; Standard deviation; Tomography, Optical Coherence - methods; Young Adult
• ISSN: 0002-9394; 1879-1891
• DOI: 10.1016/j.ajo.2014.02.008

Purpose To determine the repeatability of automated retinal and choroidal thickness measurements with swept-source optical coherence tomography (SS OCT) and the frequency and type of scan artifacts. Design Prospective evaluation of new diagnostic technology. Methods Thirty healthy subjects were recruited prospectively and underwent imaging with a prototype SS OCT instrument. Undilated scans of 54 eyes of 27 subjects (mean age, 35.1 ± 9.3 years) were obtained. Each subject had 4 SS OCT protocols repeated 3 times: 3-dimensional (3D) 6 × 6-mm raster scan of the optic disc and macula, radial, and line scan. Automated measurements were obtained through segmentation software. Interscan repeatability was assessed by intraclass correlation coefficients (ICCs). Results ICCs for choroidal measurements were 0.92, 0.98, 0.80, and 0.91, respectively, for 3D macula, 3D optic disc, radial, and line scans. ICCs for retinal measurements were 0.39, 0.49, 0.71, and 0.69, respectively. Artifacts were present in up to 9% scans. Signal loss because of blinking was the most common artifact on 3D scans (optic disc scan, 7%; macula scan, 9%), whereas segmentation failure occurred in 4% of radial and 3% of line scans. When scans with image artifacts were excluded, ICCs for choroidal thickness increased to 0.95, 0.99, 0.87, and 0.93 for 3D macula, 3D optic disc, radial, and line scans, respectively. ICCs for retinal thickness increased to 0.88, 0.83, 0.89, and 0.76, respectively. Conclusions Improved repeatability of automated choroidal and retinal thickness measurements was found with the SS OCT after correction of scan artifacts. Recognition of scan artifacts is important for correct interpretation of SS OCT measurements.