Abstract

The purpose of this study was to assess the repeatability and reproducibility of measuring the minimum linear diameter (MLD) of macular holes (MHs) using horizontal linear and radial scan modes in optical coherence tomography (OCT). Patients with concurrent sets of radial and horizontal linear OCT volume scans were included. The MLD was measured twice in both scan modes by six raters of three different experience levels (groups). Outcome measures were the reliability and repeatability of MLD measurements. Fifty patients were included. Mean MLD was 317.21(±170.63) µm in horizontal linear and 364.52 (±161.71) µm in radial mode, a difference of 47.31 (±26.48) µm (p < 0.001). In the radial scan mode, MLD was identified within 15° of the horizontal meridian in 27% and within 15° of the vertical meridian in 26.7%, with the remainder (46.3%) in oblique meridians. The intra-group coefficients of repeatability (CR) for horizontal linear mode were 23 µm, 33 µm and 45 µm, and for radial mode 25 µm, 44 µm and 57 µm for groups 1, 2 and 3, respectively. The inter-group CR, taking group 1 as reference standard for groups 2 and 3, were 74 µm and 71 µm for the linear mode, and 62 µm and 78 µm for radial mode. The radial mode provides good repeatability and reliability for measurement of MLD. In a majority of cases the MLD does not lie in the horizontal meridian and would be underestimated using a horizontal OCT mode.

Highlights

  • Optical coherence tomography (OCT) is the standard diagnostic tool for analysing the configuration and the minimum linear diameter (MLD) size of a macular hole (MH), which is used as a guide to the management of macular holes (MHs)

  • Since fixation is impaired in eyes with a MH, patients were presented with a fixation target light to their contralateral eye to obtain steady fixation while the OCTs were taken, with manual centration of the OCT raster on the centre of the MH in both modes

  • We have shown that the use of the radial mode provides comparably good repeatability and reliability to the horizontal mode for MLD measurement of MHs

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Summary

Introduction

Optical coherence tomography (OCT) is the standard diagnostic tool for analysing the configuration and the minimum linear diameter (MLD) size of a macular hole (MH), which is used as a guide to the management of MHs. For the measurement of a MH, contemporary OCT devices offer two different macular scanning profiles; one is a raster of horizontal line scans and the other one consists of radial scans around a central point In both modes, the scan is selected which displays the widest dimension of the MH and the MLD is measured manually using the built-in softer calliper tool. The horizontal linear raster scan is currently the routine mode that is most used in clinical settings as well as in major large MH trials [1,2,3,4,5,6] and has formed the basis for clinical guidelines It is known, that the shape of a MH is not uniform [7] and the widest aperture may lie in any meridian. The purpose of this study, was to compare the reliability and repeatability of MH measurements in horizontal and radial OCT modes

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