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Comparison of a commercial spectral-domain OCT and swept-source OCT based on an angiography scan for measuring circumpapillary retinal nerve fibre layer thickness
  1. Bingyao Tan1,2,
  2. Jacqueline Chua1,3,
  3. Thiyagrajan Harish1,
  4. Amanda Lau1,
  5. Alfred Tau Liang Gan1,
  6. Yar Li Tan1,4,
  7. Damon W K Wong2,5,
  8. Rachel Shujuan Chong1,3,
  9. Marcus Ang1,3,
  10. Rahat Husain1,4,
  11. Leopold Schmetterer1,3,6,7,8,9
  1. 1 Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
  2. 2 SERI-NTU Advanced Ocular Engineering (STANCE) program, Singapore, Singapore
  3. 3 Academic Clinical Program, DUKE-NUS Medical School, Singapore, Singapore
  4. 4 Changi General Hospital, Singapore, Singapore
  5. 5 Institute of Health Technologies, Nanyang Technological University, Singapore, Singapore
  6. 6 Department of Ophthalmology, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
  7. 7 Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore
  8. 8 Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
  9. 9 Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
  1. Correspondence to Professor Leopold Schmetterer, Singapore Eye Research Institute, Singapore National Eye Center, Singapore 169856, Singapore; leopold.schmetterer{at}


Background/aims To assess the agreement in measuring retinal nerve fibre layer (RNFL) thickness between spectral-domain (SD; Cirrus HD, Carl Zeiss Meditec, USA) optical coherence tomography (OCT) and swept-source (SS; Plex Elite 9000, Carl Zeiss Meditec) OCT using an OCT angiography (OCTA) scanning protocol.

Methods 57 participants (12 glaucomatous, 8 ocular hypertensive and 74 normal eyes) were scanned with two OCT instruments by a single experienced operator on the same day. Circumpapillary RNFL thicknesses were automatically segmented for SD-OCT and manually segmented for SS-OCTA scans. Agreement of global RNFL thickness, as well as average thickness in four quadrants was assessed using intraclass correlation coefficients (ICCs).

Results There was excellent agreement in the inferior and superior quadrants and the global (all ICC >0.90), followed by good agreement in the temporal (ICC=0.79) and nasal (ICC=0.73) quadrants. The ICC values were similar in the subgroups except within the ocular hypertension group, where the nasal quadrant was less agreeable (ICC=0.31). SS-OCTA-derived RNFL thickness was on average 3 µm thicker than SD-OCT, particularly in the nasal (69.7±11.5 µm vs 66.3±9.3 µm; p<0.001) and temporal (75.6±13.7 µm vs 67.9±12.3 µm; p<0.001) quadrants.

Conclusions RNFL measurements taken with SS-OCTA have good-to-excellent agreement with SD-OCT, which suggests that the RNFL thickness can be sufficiently extracted from wide-field OCTA scans.

  • retina
  • imaging
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  • Contributors LS, MA and RH conceived the idea; BT, JC, TH and DWKW conducted the data analysis; AL and YLT collected the data; AL conducted the statistical analysis; BT prepared the first draft; all authors contributed to the data interpretation; all authors contributed to the final version of the manuscript.

  • Funding This work was funded by grants from the National Medical Research Council (OFIRG/0048/2017, NMRC/CG/C010A/2017, NMRC STaR/0016/2013), Singapore.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Ethics approval This study was approved by the SingHealth Centralized Institutional Review Board and conducted in accordance to the Declaration of Helsinki.

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

  • Data availability statement Data are available on request.

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