Retinal nerve fiber layer thickness by Stratus and Cirrus OCT in retrobulbar optic neuritis and nonarteritic ischemic optic neuropathy.

Abstract

To compare retinal nerve fiber layer thickness (RNFLT) measurements by Stratus and Cirrus optical coherence tomography (OCT) and to evaluate agreement between the 2 instruments in retrobulbar optic neuritis (RON), nonarteritic ischemic optic neuropathy (NAION), and healthy controls. A total of 89 eyes with RON, 92 with NAION (6 to 12 months after diagnosis of acute disease), and 159 control eyes were studied. Average RNFLT was measured by Stratus and Cirrus OCTs. Comparisons among groups were performed by analysis of variance. Agreement between the 2 instruments was assessed using intraclass correlation coefficient (ICC) with 95% confidence interval (CI) and Bland-Altman analysis. Statistical significance was set at p≤0.05. Average RNFLT was lower in NAION eyes than in RON and control ones using both OCT devices (60.0 ± 1.2, 69.9 ± 1.2, and 97.4 ± 0.9 μm, p<0.001 by Cirrus; 49.7 ± 1.5, 65.9 ± 1.9, and 99.2 ± 1.3 μm, p<0.001 by Stratus). The RNFLT values were higher with Cirrus than with Stratus in NAION (+10.30 μm, confidence interval [CI] 7.82-12.79 μm) and RON (+4.01 μm, CI 1.32-6.70 μm) eyes, and slightly lower in control ones (-1.75 μm, CI -3.51 to 0.01 μm). A stronger agreement between the 2 instruments was found in control and RON eyes than in NAION ones (ICC 0.682, CI 0.566-0.771; 0.635, CI 0.467-0.758; 0.321, CI 0.132-0.472, respectively). Both Stratus and Cirrus OCT can identify RNFLT reduction in previous RON and NAION. Absolute RNFLT values differ between the 2 instruments; hence they are not to be considered interchangeable.