In vivo laminar and pre-laminar tissues measurements with enhanced depth imaging spectral-domain optical coherence tomography

In vivo laminar and pre-laminar tissues measurements with enhanced depth imaging spectral-domain optical coherence tomography

Author Prado, Vitor Gomes Autor UNIFESP Google Scholar
Advisor Prata, Tiago dos Santos Prata Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Graduate program Tecnologias e Atenção à Saúde
Abstract Purpose: To investigate the ability of glaucoma specialists to identify different laminar and prelaminar optic nerve head (ONH) structures and determine the interobserver and intraobserver reproducibility of these measurements obtained by enhanced depth imaging spectral-domain optical coherence tomography (EDI-OCT) in a population with and without glaucoma. Design: Observational case-control study. Methods: We prospectively enrolled glaucomatous patients with a wide range of disease stage and healthy individuals. A complete ophthalmological examination was performed and patients with significant media opacity or any ocular disease (besides glaucoma) were excluded. All participants underwent EDI-OCT imaging (SD-OCT; Spectralis). The following ONH parameters were measured on serial vertical EDI-OCT B-scans by two experienced examiners masked to patients clinical data: lamina cribrosa (LC) and pre-laminar neural tissue thicknesses, Bruch?s membrane opening (BMO) and cup depth (CD). Only good quality images were considered and whenever both eyes were eligible, one was randomly selected. Identification of each parameter was graded as easy, difficult or impossible. In addition, we determined the interobserver and intraobserver reproducibilities of each EDI-OCT parameter. Results: A total of 25 eyes of 25 patients were included (mean age, 54.3±25.2 years). Overall, the anterior surface of the pre-laminar neural tissue and the borders of the Bruch?s membrane opening were the landmarks most clearly identified (graded as easy in over 90% of the eyes on average). On the other hand, the posterior surface of the lamina cribrosa was clearly identified in less than 35% of the cases on average. Comparing the eyes in which most parameters were easily identified with those that showed poor visibility, the former group was mostly composed by eyes with glaucoma, with larger cup-to-disc ratio (mean of 0.72 vs 0.30; p<0.05) and a thinner prelaminar neural tissue layer (mean of 188 vs 390 ?m; p<0.5). Overall, cup depth and BMO had the best and LC thickness had the worst intraobserver and interobserver reproducibilities values. Conclusions: Most pre-laminar ONH structures could be clearly identified by different glaucoma specialists using EDI-OCT, with a good intraobserver and interobserver reproducibility. Best results were found for pre-laminar tissues and landmarks compared to deeper ONH structures, such as the lamina cribrosa, that seems to be not always feasible, especially in cases of normal eyes with healthy ONH.

Purpose: To investigate the ability of glaucoma specialists to identify different laminar and prelaminar optic nerve head (ONH) structures and determine the interobserver and intraobserver reproducibility of these measurements obtained by enhanced depth imaging spectral-domain optical coherence tomography (EDI-OCT) in a population with and without glaucoma. Design: Observational case-control study. Methods: We prospectively enrolled glaucomatous patients with a wide range of disease stage and healthy individuals. A complete ophthalmological examination was performed and patients with significant media opacity or any ocular disease (besides glaucoma) were excluded. All participants underwent EDI-OCT imaging (SD-OCT; Spectralis). The following ONH parameters were measured on serial vertical EDI-OCT B-scans by two experienced examiners masked to patients clinical data: lamina cribrosa (LC) and pre-laminar neural tissue thicknesses, Bruch?s membrane opening (BMO) and cup depth (CD). Only good quality images were considered and whenever both eyes were eligible, one was randomly selected. Identification of each parameter was graded as easy, difficult or impossible. In addition, we determined the interobserver and intraobserver reproducibilities of each EDI-OCT parameter. Results: A total of 25 eyes of 25 patients were included (mean age, 54.3±25.2 years). Overall, the anterior surface of the pre-laminar neural tissue and the borders of the Bruch?s membrane opening were the landmarks most clearly identified (graded as easy in over 90% of the eyes on average). On the other hand, the posterior surface of the lamina cribrosa was clearly identified in less than 35% of the cases on average. Comparing the eyes in which most parameters were easily identified with those that showed poor visibility, the former group was mostly composed by eyes with glaucoma, with larger cup-to-disc ratio (mean of 0.72 vs 0.30; p<0.05) and a thinner prelaminar neural tissue layer (mean of 188 vs 390 ?m; p<0.5). Overall, cup depth and BMO had the best and LC thickness had the worst intraobserver and interobserver reproducibilities values. Conclusions: Most pre-laminar ONH structures could be clearly identified by different glaucoma specialists using EDI-OCT, with a good intraobserver and interobserver reproducibility. Best results were found for pre-laminar tissues and landmarks compared to deeper ONH structures, such as the lamina cribrosa, that seems to be not always feasible, especially in cases of normal eyes with healthy ONH.
Keywords enhanced depth imaging
optical coherence tomography
optic nerve head
reproducibility
enhanced depth imaging (edi)
optical coherence tomography (oct)
optic nerve head (onh)
reproducibility
Language English
Date 2014-11-28
Published in PRADO, Vitor Gomes. In vivo laminar and pre-laminar tissues measurements with enhanced depth imaging spectral-domain optical coherence tomography. 2014. 24 f. Dissertação (Mestrado Profissional) - Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, 2014.
Research area Medicina
Knowledge area Ciências da saúde
Publisher Universidade Federal de São Paulo (UNIFESP)
Extent 24 p.
Origin https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=1513634
Access rights Closed access
Type Dissertação de mestrado profissional
URI http://repositorio.unifesp.br/handle/11600/46742

Show full item record




File

File Size Format View

There are no files associated with this item.

This item appears in the following Collection(s)

Search


Browse

Statistics

My Account