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Intra and inter‐rater agreement of anterior lamina cribrosa depth measurements using enhanced‐depth imaging optical coherence tomography
Author(s) -
Leal I.,
Cordeiro Sousa D.,
Couceiro R.,
Barata A.,
Abegao Pinto L.,
Pinto F.,
MarquesNeves C.
Publication year - 2015
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2015.0648
Subject(s) - intraclass correlation , medicine , lamina , optical coherence tomography , nuclear medicine , limits of agreement , ophthalmology , population , concordance , anatomy , psychometrics , clinical psychology , environmental health
Purpose To determine intra and inter‐rater agreement of anterior lamina cribrosa depth ( ALCD ) manual measurements using enhanced depth imaging spectral‐domain optical coherence tomography ( EDI ‐ OCT ). Methods Double blind prospective observational study between December 14 and May 15. EDI ‐ OCT of optic nerve head was performed in subjects with an irrelevant ophthalmologic history (2 cross scans: vertical and horizontal). ALCD was defined as the perpendicular distance between the line connecting both edges of Bruch's membrane and the anterior border of the lamina cribrosa, at the maximum depth point. Two double‐blinded experienced operators manually measured ALCD twice, with a one‐month interval. Intra and inter‐rater agreement was evaluated using intraclass correlation coefficients ( ICC ), concordance correlation coefficients ( CCC ) and Bland‐Altman ( BA ) plots for the right eye vertical ( RV ) and horizontal ( RH ) scans and left eye vertical ( LV ) and horizontal ( LH ) scans. Statistical analyses were performed using STATA 13.0. Results Studied population included 44 subjects (26 women), with a mean age of 62.9 ± 14.3 years. Mean vertical and horizontal maximum ALCD was 453.3 ± 88 μm and 436.1 ± 78.7 μm, respectively. Intra‐rater ICC for ALCD in RV , RH , LV and LH were 0.98, 0.94, 0.97 and 0.96, respectively. Inter‐rater ICC for ALCD in RV , RH , LV and LH were all 0.99. Intra‐rater CCC for ALCD in RV , RH , LV and LH were 0.98, 0.93, 0.97 and 0.96. Inter‐rater CCC for ALCD in RV , RH , LV and LH were all 0.99. Bland–Altman plots suggested that almost all observations were within the 95% limits of agreement. Conclusions ALCD manual measurements with EDI ‐ OCT showed high agreement among intra and inter‐rater measurements in healthy eyes. EDI ‐ OCT is a reliable tool for ALCD measurement, which can provide potentially useful information for integrated glaucoma management.