EXTENDED REPORT

Digital imaging of the optic nerve head: monoscopic and stereoscopic analysis

J E Morgan^1,2, N J L Sheen², R V North², Y Choong¹ and E Ansari¹

¹ Department of Ophthalmology, University Hospital of Wales, Heath Park, Cardiff CF4 4XW, UK
² Department of Optometry and Vision Sciences, Cardiff University, Redwood Building, Edward VII Avenue, Cardiff CF10 3NB, UK

Correspondence to:
Correspondence to:
J E Morgan
Department of Ophthalmology, University Hospital of Wales, Heath Park, Cardiff CF4 4XW, UK; morganje3{at}cardiff.ac.uk

Aims: To compare monoscopic and stereoscopic assessment of the optic disc using novel software for the digital stereoscopic analysis of optic disc stereopairs.

Methods: Software was developed for the stereoscopic display of digital optic disc images using an interlaced display method. Neuroretinal rim width was determined at 10 degree intervals around the optic disc using a custom (stereoscopic) cursor whose depth was adjusted to that of Elschnig’s rim. Measurements were taken, first viewing the disc monoscopically and at a separate sitting, stereoscopically.

Results: Measurements were made in 35 eyes from 35 patients (1260 estimates for each observer) using three observers. The mean cup to disc ratio (CDR) ranged from 0.57 to 0.66 (SD 0.13–0.14) for monoscopic viewing compared with 0.64 to 0.69 (SD 0.12–0.14) for stereoscopic viewing. Stereoscopic assessments gave higher CDRs in temporal, superior, nasal, and inferior aspects of the optic disc (p<0.001, Mann-Whitney U test). Agreement between observers in estimating CDR was high for monoscopic assessment (intraclass correlation coefficient 0.74 (CI 0.72 to 0.76) increasing to 0.80 (0.78 to 0.82) for stereoscopic assessment.

Conclusion: Digital stereoscopic optic disc assessment provides lower estimates of neuroretinal rim width and higher levels of interobserver agreement compared with monoscopic assessments.

Abbreviations: CDR, cup to disc ratio; ICC, intraclass correlation coefficient; IOP, intraocular pressure; LC, liquid crystal

Keywords: digital imaging; optic nerve head

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