Comparison of optical coherence tomography and fundus photography for measuring the optic disc size

To assess the agreement and repeatability of optic nerve head (ONH) size measurements by optical coherence tomography (OCT) as compared to conventional planimetry of fundus photographs in normal eyes.

For comparison with planimetry the absolute size of the ONH of 25 eyes from 25 normal subjects were measured by both OCT and digital fundus photography (Zeiss FF camera 450). Repeatability of automated Stratus OCT measurements were investigated by repeatedly measuring the optic disc in five normal subjects.

Mean disc size was 1763 +/- 186 vertically and 1632 +/- 160 microm horizontally on planimetry. On OCT, values of 1772 +/- 317 microm vertically (p = 0.82) and a significantly smaller horizontal diameter of 1492 +/- 302 microm (p = 0.04) were obtained. The 95% limits of agreement were (-546 microm; +527 microm) for vertical and (-502 microm; +782 microm) for horizontal planimetric compared to OCT measurements. In some cases large discrepancies existed. Repeatability of automatic measurements of the optic disc by OCT was moderately good with intra-class correlation coefficients (ICC) of 0.78 horizontally and 0.83 vertically. The coefficient of repeatability indicating instrument precision was 80 microm for horizontal and 168 microm for vertical measurements.

OCT can be used to determine optic disc margins in moderate agreement with planimetry in normal subjects. However, in some cases significant disagreement with photographic assessment may occur making manual inspection advisable. Automatic disc detection by OCT is moderately repeatable.