Comparison of Retinal Nerve Fiber Layer Thickness in Normal Eyes Using Time-Domain and Spectral-Domain Optical Coherence Tomography

PURPOSE: To compare retinal nerve fiber layer (RNFL) thickness measurements between 3 different spectral-domain optical coherence tomography (SD-OCT) instruments (Spectralis; Heidelberg Engineering; Cirrus; Carl Zeiss Meditec; RTVue; Optovue, Inc) and one time-domain OCT (Stratus; Carl Zeiss Meditec). DESIGN: Prospective, cross-sectional study. METHODS: RNFL thickness was measured on both eyes of 40 normal subjects using Stratus, Spectralis, RTVue, and Cirrus OCT on the same day. Scans were repeated 2 to 8 weeks later in the same fashion. Agreement with Stratus was evaluated for each SD-OCT and intervisit reproducibility was assessed for all machines. RESULTS: Mean RNFL thickness determined by each of the 3 SD-OCT instruments was highly correlated with Stratus (r = 0.87-0.91). The mean RNFL thickness (mean standard deviation) was 110.1 +/- 12.8 mu m for Stratus, 106.6 +/- 12.8 mu n for Spectralis, 98.7 +/- 10.9 mu m for Cirrus, and 112.8 +/- - 13.2 mu m for RTVue. The average differences between each SD-OCT and Stratus for mean RNFL thickness were all statistically significant (P <= 001), as were most: quadrant measurements. All 4 instruments demonstrated excellent intraclass correlation coefficient values for mean RNFL thickness (0.90-0.97). However, intervisit variability was lowest for RTVue as evidenced by reproducibility values, followed by Stratus, Cirrus, and Spectralis (6.59, 8.83, 8.89, and 11.72 respectively). CONCLUSIONS: RNFL measurements taken with Spectrails, RTVue, and Cirrus all have excellent correlation to Stratus, with good reproducibility in normal eyes. Despite high correlations, RNFL values are significantly different between instruments and should not be used interchangeably. (Am J Ophthalmol 2010;150:807-814. (C) 2010 by Elsevier Inc. All rights reserved.)