Inter‐ and intra‐image variability in computer‐assisted optic nerve head assessment

Abstract

A computer-assisted system for optic nerve head analysis was used to measure one eye from each of 15 subjects. These comprised three groups of five, being glaucomatous, ocular hypertensive, and normal subjects. Each eye was imaged with the system 10 times. The 150 images produced were analysed in a randomized masked fashion to test the inter-image variability of the measurements. Linear pallor: disc ratios had mean coefficients of variation of 6.6% (normal), 4.8% (ocular hypertensive) and 2.6% (glaucomatous). This trend of reducing coefficient of variation from normal to ocular hypertensive to glaucomatous was reflected in other parameters also. Intra-image variability was assessed by analysing one image from each subject 10 times, in a randomized masked fashion. The mean coefficients of variation of the linear pallor: disc ratios were 6.3% (normal), 3.6% (ocular hypertensive) and 3.2% (glaucomatous). Fisher's F-test showed that no parameters had significantly lower intra-image rather than inter-image variance (at the 5% level). Variability is apparently due to operator variations rather than the image variations.