Reproducibility of Choroidal Thickness Measurements Across Three Spectral Domain Optical Coherence Tomography Systems

Purpose: To investigate the reproducibility of choroidal thickness measurements in normal subjects on 3 spectral domain optical coherence tomography (SD-OCT) instruments: Zeiss Cirrus HD-OCT (Carl Zeiss Meditec Inc., Dublin, CA), Heidelberg Spectralis (Heidelberg Engineering, Heidelberg, Germany), and Optovue RTVue (Optovue Inc., Fremont, CA).Design: Cross-sectional non-interventional study.Participants: Images were obtained in 28 eyes of 28 healthy undilated volunteers without ocular pathology in a clinical setting.Methods: All subjects were imaged on the fovea using Cirrus HD 1-line raster, Spectralis enhanced depth imaging (EDI), and RTVue retina-cross.Main Outcome Measures: the choroid was measured subfoveally, 750 mu m temporal, and 750 mu m nasal to the fovea. All measurements were performed by 2 independent observers. Two-way analysis of variance (ANOVA) with Bonferroni's post-test, Pearson correlation, and Bland-Altman analysis were used to compare measurements.Results: the group of 28 subjects consisted of 7 men and 21 women, with an average age of 35.2 years (range, 23-64 years). A 2-way ANOVA with Bonferroni's post-test revealed no significant difference in the average subfoveal choroidal thickness (P > 0.05) among systems for any location: subfoveally, 750 mu m temporal, and 750 mu m nasal to the fovea. the measurements of choroidal thickness from any pair of 3 instruments (Cirrus vs. Spectralis, Cirrus vs. RTVue, Spectralis vs. RTVue) were also strongly correlated. the Pearson correlation among all 2 system pairs of the 3 systems was greater than 0.9 (P < 0.0001). the 95% limits of agreement among 4 choroidal thickness measurements were +11.21% to -13.57% (bias -1.17) between Cirrus and RTVue, +10.85% to -12.45% (bias -0.80) between Spectralis and RTVue, and +12.81% to -13.33% (bias -0.25) between Cirrus and Spectralis.Conclusions: in our population of young healthy adults with normal vision, there was good reproducibility among choroidal thickness measurements of images acquired with Cirrus, Spectralis, and RTVue.Financial Disclosure(s): Proprietary or commercial disclosure may be found after the references. Ophthalmology 2012; 119: 119-123 (C) 2012 by the American Academy of Ophthalmology.Research to Prevent BlindnessNational Institutes of HealthAir Force Office of Scientific ResearchTufts Univ New England Med Ctr, Tufts Med Ctr, Boston, MA 02111 USABoston Univ, Sch Med, Boston, MA 02118 USAUniversidade Federal de São Paulo, São Paulo, BrazilUniv Hosp Albacete, Albacete, SpainMIT, Elect Res Lab, Dept Elect Engn & Comp Sci, Cambridge, MA 02139 USAUniversidade Federal de São Paulo, São Paulo, BrazilNational Institutes of Health: RO1-EY11289-25National Institutes of Health: R01-EY13178-10National Institutes of Health: R01-EY013516-07National Institutes of Health: R01-EY019029-02Air Force Office of Scientific Research: FA9550-10-1-0551Air Force Office of Scientific Research: FA9550-10-1-0063Web of Scienc