Comparison of optical coherence tomography assessments in the comparison of age-related macular degeneration treatments trials

Francisco A Folgar; Glenn J Jaffe; Gui-Shuang Ying; Maureen G Maguire; Cynthia A Toth; Comparison of Age-Related Macular Degeneration Treatments Trials Research Group

doi:10.1016/j.ophtha.2014.04.020

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Comparison of optical coherence tomography assessments in the comparison of age-related macular degeneration treatments trials

Journal article

Peer reviewed

Comparison of optical coherence tomography assessments in the comparison of age-related macular degeneration treatments trials

Francisco A Folgar, Glenn J Jaffe, Gui-Shuang Ying, Maureen G Maguire, Cynthia A Toth and Comparison of Age-Related Macular Degeneration Treatments Trials Research Group

Ophthalmology (Rochester, Minn.), Vol.121(10), pp.1956-1965.e2

10/2014

DOI: 10.1016/j.ophtha.2014.04.020

PMCID: PMC4515372

PMID: 24835760

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http://doi.org/10.1016/j.ophtha.2014.04.020View

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Abstract

To determine agreement between spectral-domain (SD) and time-domain (TD) optical coherence tomography (OCT) image assessments by certified readers in eyes treated for neovascular age-related macular degeneration (AMD). Cross-sectional study within the Comparison of AMD Treatments Trials (CATT). During year 2 of CATT, 1213 pairs of SD OCT and TD OCT scans were compared from a subset of 384 eyes. Masked readers independently graded OCT scans for presence of intraretinal fluid (IRF), subretinal fluid (SRF), and sub-retinal pigment epithelium (RPE) fluid and performed manual measurements of retinal, SRF, and subretinal tissue complex thicknesses at the foveal center. Presence of fluid was evaluated with percent agreement, κ coefficients with 95% confidence intervals (CIs), and McNemar tests. Thickness measurements were evaluated with mean difference (Δ) ±95% limits of agreement and intraclass correlation coefficients (ICCs) with 95% CIs. Between SD OCT and TD OCT, agreement on presence of any fluid was 82% (κ = 0.46; 95% CI, 0.40-0.52), with 5% more SD OCT scans demonstrating fluid (P<0.001). Agreement on presence of SRF was 87% and sub-RPE fluid was 80%, with more SD OCT scans demonstrating fluid (both P < 0.001). Agreement on IRF was 73% (κ = 0.47; 95% CI, 0.42-0.52), with 6% more TD OCT scans demonstrating fluid (P < 0.001). Between SD OCT and TD OCT, mean thickness of the retina was Δ = 5±67 μm, SRF was Δ = 1.5±35 μm, and subretinal tissue complex was Δ = 5±86 μm. Thickness measurements were reproducible for retina (ICC = 0.84; 95% CI, 0.83-0.86), SRF (ICC = 0.88; 95% CI, 0.86-0.89), and subretinal tissue complex (ICC = 0.91; 95% CI, 0.89-0.92), with ≤25-μm difference in these measurements in 71%, 94%, and 61% of paired scans, respectively. Agreement on fluid presence and manual thickness measurements between paired scans from each OCT modality was moderate, providing a reasonable basis to compare CATT results with future SD OCT-based trials. Fluid was detected 5% more frequently with SD OCT, which may increase frequency of fluid-based treatment. Lower-resolution and artifactual interpretation of dark areas as cystoid edema may explain the greater frequency of IRF detected with TD OCT.

Reproducibility of Results

Antibodies, Monoclonal, Humanized - therapeutic use

Prospective Studies

Cross-Sectional Studies

Humans

Tomography, Optical Coherence - methods

Macular Degeneration - diagnosis

Macular Degeneration - drug therapy

Bevacizumab

Ranibizumab

Angiogenesis Inhibitors - therapeutic use

Tomography, Optical Coherence - standards

Adult

Details

Title: Subtitle: Comparison of optical coherence tomography assessments in the comparison of age-related macular degeneration treatments trials
Creators: Francisco A Folgar - Department of Ophthalmology, Duke University, Durham, North Carolina
Glenn J Jaffe - Department of Ophthalmology, Duke University, Durham, North Carolina
Gui-Shuang Ying - Department of Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania
Maureen G Maguire - Department of Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania
Cynthia A Toth - Department of Ophthalmology, Duke University, Durham, North Carolina. Electronic address: cynthia.toth@dm.duke.edu
Comparison of Age-Related Macular Degeneration Treatments Trials Research Group
Contributors: James C Folk (Contributor) - University of Iowa, Ophthalmology and Visual Sciences
Douglas B Critser (Contributor) - University of Iowa, The University of Iowa Institute for Vision Research
Stephen R Russell (Contributor) - University of Iowa, Ophthalmology and Visual Sciences
Heather A Stockman (Contributor) - University of Iowa, Ophthalmology and Visual Sciences
Resource Type: Journal article
Publication Details: Ophthalmology (Rochester, Minn.), Vol.121(10), pp.1956-1965.e2
DOI: 10.1016/j.ophtha.2014.04.020
PMID: 24835760
PMCID: PMC4515372
NLM abbreviation: Ophthalmology
ISSN: 0161-6420
eISSN: 1549-4713
Publisher: United States
Grant note: U10 EY017828 / NEI NIH HHS U10 EY017825 / NEI NIH HHS U10 EY017823 / NEI NIH HHS
Language: English
Date published: 10/2014
Academic Unit: The University of Iowa Institute for Vision Research; Ophthalmology and Visual Sciences
Record Identifier: 9983980079902771

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