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. 2001 Jun;85(6):673–677. doi: 10.1136/bjo.85.6.673

The Humphrey optical coherence tomography scanner: quantitative analysis and reproducibility study of the normal human retinal nerve fibre layer

A Jones 1, N Sheen 1, R North 1, J Morgan 1
PMCID: PMC1723988  PMID: 11371486

Abstract

BACKGROUND/AIMS—To determine the reproducibility of the Humphrey optical coherence tomography scanner (OCT), software version 5.0, for measurement of retinal nerve fibre layer (RNFL) thickness in normal subjects and to compare OCT measurements with published histological thickness of the human RNFL.
METHODS—Three independent measurements were obtained at each session for one eye from 15 normal subjects with a mean age of 30.8 (SD 10.9) years. Scans were taken in the peripapillary retina using the default setting (1.74 mm radius from centre of the optic disc) and were repeated 1 week later. Additional scans were obtained at the optic nerve head (ONH) margin overlying the scleral rim, for comparison with available histological data on the human RNFL.
RESULTS—For the 1.74 mm circular scan, the mean coefficient of variation (COV) for the global RNFL thickness measurement was 5% (SD 3%). This increased to 8% (3%) for quadrant measurements and to 9% (3%) with further subdivision into 12 segments. Significant differences (p<0.05) between sessions were only found when the data were divided into segments. The mean RNFL thickness for the 1.74 mm scan was 127.87 (9.81) µm. The RNFL was maximal at the superior disc pole, 161.44 µm (14.8), and minimal at the temporal pole, 83.1 (12.8) µm. Peak thickness values occurred superior temporal and inferior temporal to the vertical axis. RNFL thickness for every sector of the disc was greatest at the margin of the optic disc (mean 185.79 µm; SD 32.61). Although the variation in RNFL thickness around the disc follows published histology data, the OCT underestimates RNFL thickness by an average of 37% (SD 11; range 21-48%).
CONCLUSION—The OCT provides reproducible measurement of the retinal structures that are consistent with the properties of the RNFL. However, comparison with available studies of RNFL thickness in the human suggests that in its present form, the OCT underestimates RNFL thickness. Further refinement of this technology is required to improve the accuracy with which the OCT measures retinal nerve fibre layer thickness.



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Figure 1  .

Figure 1  

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Operator monitor images showing the scan patterns with indication of scan direction (RE), (A) 1.74 mm circle scan, (B) ONH margin scan.

Figure 2  .

Figure 2  

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Raw data image as supplied by the commercial OCT software, the arrows indicate the RNFL. N = nasal, S = superior, T = temporal, I = inferior.

Figure 3  .

Figure 3  

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Plot of the mean RNFL thickness per segment for each session using the 1.74 mm circle scan, error bars indicate 1 SD from the mean. Open circles represent values from session 1; solid circles from session 2. N = nasal, S = superior, T = temporal, I = inferior.

Figure 4  .

Figure 4  

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Plot of RNFL thickness according to angular location around the optic disc circumference. N = nasal, S = superior, T = temporal, I = inferior. Plots marked "OCT" represent values obtained by the OCT scan at the ONH margin. Those marked "Dichtl et al" and "Varma et al" represent RNFL thickness at the ONH margin as published by Dichtl et al,36 and Varma et al,35 respectively. Note the difference in modulation of the RNFL as measured by histology.

Figure 5  .

Figure 5  

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Polar frequency histogram showing the distribution of the maxima and minima for RNFL thickness at the ONH margin as measured by the OCT. N = nasal, S = superior, T = temporal, I = inferior. Scale bar shows representation for one subject.

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