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Repeatability and Reproducibility of Choroidal Vessel Layer Measurements in Diabetic Retinopathy Using Enhanced Depth Optical Coherence Tomography

Authors :
Dawn A Sim
Pearse A. Keane
Praveen J. Patel
Catherine A Egan
Marcus Fruttiger
Hemal Mehta
Adnan Tufail
Simon S M Fung
Javier Zarranz-Ventura
Source :
Investigative Opthalmology & Visual Science. 54:2893
Publication Year :
2013
Publisher :
Association for Research in Vision and Ophthalmology (ARVO), 2013.

Abstract

Purpose To describe novel segmentation protocols for choroidal layers, Sattler's medium and Haller's large vessel layers, using enhanced depth imaging optical coherence tomography (EDI-OCT), and to examine the repeatability and reproducibility of these measurements in eyes with diabetic retinopathy. Methods Fifty-one patients with Type 2 diabetes mellitus were imaged using custom EDI scanning protocols. Detailed segmentation was performed to quantify the retina, choroid, Haller's large, and Sattler's medium vessel layers in the total macular circle (TMC) and foveal central subfield (FCS). The coefficient of repeatability (CR) and intraclass correlation coefficient (ICC) were used as a measure of repeatability and relative reliability within graders. Reproducibility or interobserver variability was assessed using Bland-Altman plots and 95% limits of agreement (LoA). Results Intragrader CR of the retina, choroid, Sattler's, and Haller's layers for thickness measurements were 19.2, 26.9, 35.2, and 29.2 μm, respectively. Intergrader 95% LoA were 27.9, 41.5, 38.6, 31.1 μm (thickness), respectively. Choroidal sublayer measurements showed good intraobserver reliability (ICC 0.78-0.98). Interobserver variability for retinal and choroidal measurements was not significantly different (P > 0.45). Measurements from the TMC showed slightly better repeatability and agreement compared with the FCS alone. Mean intergrader differences were reduced after training, and were most apparent in choroidal sublayers. Conclusions The choroidal vascular sublayers can be quantified with good reliability, repeatability, and reproducibility. Accurate quantitative assessment of these sublayers may provide new insights into the role of the choroid in visual loss in patients with diabetic retinopathy, and prove useful for future clinical trials.

Details

ISSN :
15525783
Volume :
54
Database :
OpenAIRE
Journal :
Investigative Opthalmology & Visual Science
Accession number :
edsair.doi.dedup.....38b5c7b80b50a1b04d0212bcad9db108