Reproducibility of Retinal Thickness Measurements across Spectral-Domain Optical Coherence Tomography Devices using Iowa Reference Algorithm

TL;DR

This study demonstrates that using the Iowa Reference Algorithm with scanner-specific bias correction achieves consistent retinal thickness measurements across multiple spectral-domain OCT devices, enabling reliable multi-center and longitudinal studies.

Contribution

The paper introduces a method combining the Iowa Reference Algorithm with bias correction to standardize retinal thickness measurements across different OCT scanners.

Findings

All pairwise scanner differences were constant (p=0.992).

Bias correction enables scanner-agnostic measurements.

Facilitates multi-center studies with heterogeneous devices.

Abstract

PURPOSE: Establishing and obtaining consistent quantitative indices of retinal thickness from a variety of clinically used Spectral-Domain Optical Coherence Tomography scanners. DESIGN: Retinal images from five Spectral-Domain Optical Coherence Tomography scanners were used to determine total retinal thickness with scanner-specific correction factors establishing consistency of thickness measurement across devices. PARTICIPANTS: 55 Fovea-centered Spectral-Domain Optical Coherence Tomography volumes from eleven subjects were analyzed, obtained from Cirrus HD-OCT, RS-3000, Heidelberg Spectralis, RTVue and Topcon2000, seven subjects with retinal diseases and four normal controls. METHOD: The Iowa Reference Algorithm measured total retinal thickness. Nonlinear model of total retinal thickness measurement comparisons was derived and used for device-specific comparisons. Bland-Altman plots and pairwise predictive equations yielded pairwise scanner-specific differences. Mendel test determined whether measurement biases were constant for each scanner pair. RESULTS: Mendel test revealed that all pairwise scanner differences of total retinal thickness were constant across the cohort (p=0.992). Individual measurements can thus be bias-corrected and the Iowa Reference Algorithm serve as a scanner-agnostic independent standard of total retinal thickness across the five tested SD-OCT scanners. CONCLUSIONS: Combination of the Iowa Reference Algorithm with scanner-specific bias correction yields cross-scanner consistency of total retinal thickness measurements, facilitating scanning-device independent quantitative assessment of total retinal thickness, longitudinal follow-up quantification without requiring patients to be imaged on the same scanner model, and allowing for multi-center studies with heterogeneous device utilization when using the Iowa Reference Algorithm.