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Comparison of swept-source and enhanced depth imaging spectral-domain optical coherence tomography in quantitative characterisation of the optic nerve head
  1. Dejiao Li1,2,
  2. Elise V Taniguchi2,
  3. Sophie Cai2,
  4. Eleftherios I Paschalis2,3,
  5. Haobing Wang2,
  6. John B Miller2,
  7. Angela V Turalba2,
  8. Scott H Greenstein2,
  9. Stacey Brauner2,
  10. Louis R Pasquale2,4,
  11. Lucy Q Shen2
  1. 1Department of Ophthalmology, China-Japan Friendship Hospital, Beijing, China
  2. 2Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA
  3. 3Boston Keratoprosthesis Laboratory, Massachusetts Eye and Ear Infirmary, Schepens Eye Research Institute, Boston, Massachusetts, USA
  4. 4Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
  1. Correspondence to Dr Lucy Q Shen, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, 243 Charles Street, Boston, MA 02114, USA; lucy_shen{at}


Aims To compare swept-source optical coherence tomography (SS-OCT) and enhanced depth imaging spectral-domain OCT (EDI-OCT) in quantitative assessment of optic nerve head (ONH) parameters.

Methods In a cross-sectional study, patients with primary open angle glaucoma (POAG) and age-matched control subjects underwent SS-OCT and EDI-OCT B-scans of the ONH in a single visit. Two masked readers independently measured the horizontal and vertical lamina cribrosa depth (LCDH and LCDV, respectively), as well as thinnest Bruch's membrane opening minimum rim width (BMO-MRW) from SS-OCT and EDI-OCT scans. We assessed agreement between SS-OCT and EDI-OCT measurements by linear regression models, Bland-Altman analysis and concordance correlation coefficients (CCC). Intrareader and inter-reader reproducibility was assessed using intraclass correlation coefficients (ICC).

Results One eye from each of 40 patients with POAG and 20 controls were included. All three ONH measurements were higher on SS-OCT than on EDI-OCT, with significant differences in LCDH (mean difference=31.7 µm, p<0.01) and thinnest BMO-MRW (mean difference=20.5 µm, p<0.01). Linear regression models described the agreement between SS-OCT and EDI-OCT measurements with R2>0.8 for LCDH among both patients with POAG and controls and for thinnest BMO-MRW among patients with POAG. The CCC was >0.8 overall for each parameter. Intrareader and inter-reader ICCs were ≥0.989 and ≥0.964, respectively, for all parameters.

Conclusions LCDH, LCDV and thinnest BMO-MRW measurements are not interchangeable between SS-OCT and EDI-OCT, but show good intrareader and inter-reader reproducibility and interdevice agreement for quantitative characterisation of the ONH, particularly among patients with glaucoma.

  • Optic Nerve
  • Glaucoma
  • Imaging

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  • Contributors All authors have made substantial contributions to the conception or design of the work, or the acquisition, analysis or interpretation of data for the work, and drafting the work or revising it critically for important intellectual content. All authors gave final approval of the version to be published and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

  • Funding This study was supported by the Harvard Glaucoma Center of Excellence and the Miller Research Funds at the Massachusetts Eye and Ear Infirmary. LRP is supported by a Harvard Medical School Distinguished Scholar Award. LQS is supported by the Eleanor and Miles Shore Fellowship, Harvard Medical School.

  • Competing interests LRP has been a speaker for Allergan. He also served as a paid consultant to Novartis, and Bausch and Lomb. He has received support to travel to attend various meetings from the Glaucoma Foundation in NYC, Aerie Pharmaceuticals and Glaukos.

  • Patient consent Obtained.

  • Ethics approval Massachusetts Eye and Ear Infirmary Institutional Review Board.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Raw data which contributed to the correlation and Bland-Altman plots in figure 2 are available to be shared upon request.

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