Analysis of Normal Peripapillary Choroidal Thickness via Spectral Domain Optical Coherence Tomography Citation

PURPOSE—To analyze the normal peripapillary choroidal thickness utilizing a commercial spectral domain optical coherence tomography (OCT) device and determine the inter-grader reproducibility of this method. DESIGN—Retrospective, non-comparative, non-interventional case series. PARTICIPANTS—Thirty-six eyes of 36 normal patients seen at the New England Eye Center between April and September 2010. METHODS—All patients underwent high-definition scanning with the Cirrus HD-OCT. Two raster scans were obtained per eye, a horizontal and a vertical scan, both of which were centered at the optic nerve. Two independent graders individually measured the choroidal thickness. Choroidal thickness was measured from the posterior edge of the retinal pigment epithelium to the choroid-scleral junction at 500 μm intervals away from the optic nerve in the superior, inferior, nasal and temporal quadrants. Statistical analysis was conducted to compare mean choroidal thicknesses. Inter-grader reproducibility was assessed by intraclass correlation coefficient and Pearson’s correlation coefficient. Average choroidal thickness in each quadrant was compared to retinal nerve fiber layer (RNFL) thickness in their respective quadrants. MAIN OUTCOME MEASURES—Peripapillary choroidal thickness, intraclass coefficient, Pearson’s correlation coefficient. RESULTS—The peripapillary choroid in the inferior quadrant was significantly thinner compared to all other quadrants (p< 0.001). None of the other quadrants were significantly © 2011 American Academy of Ophthalmology, Inc. Published by Elsevier Inc. All rights reserved. Corresponding Author/Reprints: Jay S. Duker, MD, Department of Ophthalmology, Chairman, Tufts Medical Center, 800 Washington St., Box #450, Boston, MA, 02111, Tel: 617-636-4677; Fax: 617-636-4866, [email protected]. Financial Disclosures James G. Fujimoto, P, receives royalties from intellectual property owned by M.I.T. and licensed to Carl ZeissMeditech, Inc.; O, has stock options in Optovue, Inc.. Jay S. Duker, S, receives research support from Carl ZeissMeditech, Inc., Optovue, Inc., and Topcon Medical Systems, Inc.. Disclosures The sponsors had no role in the design or conduct of this research. Authors with financial/conflicting interests are listed after references. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH Public Access Author Manuscript Ophthalmology. Author manuscript; available in PMC 2012 October 1. Published in final edited form as: Ophthalmology. 2011 October ; 118(10): 2001–2007. doi:10.1016/j.ophtha.2011.02.049. N IH PA Athor M anscript N IH PA Athor M anscript N IH PA Athor M anscript different from each other in terms of thickness. The inferior peripapillary choroid was significantly thinner compared to all other quadrants at all distances measured away from the optic nerve (p< 0.001). Generally, the peripapillary choroid increases in thickness the farther it was away from the optic nerve and eventually approaching a plateau. Intraclass correlation coefficient ranged from 0.62 to 0.93 and Pearson’s correlation coefficient ranged from 0.74 to 0.95 (p< 0.001). Neither RNFL thickness nor average age was significantly correlated with average choroidal thickness. CONCLUSIONS—Manual segmentation of the peripapillary choroidal thickness is reproducible between graders suggesting that this method is accurate. The inferior peripapillary choroid was significantly thinner than all other quadrants (p< 0.001).