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Normative Data and Conversion Equation for Spectral-Domain Optical Coherence Tomography in an International Healthy

Rachel Kenney1, Mengling Liu, Lisena Hasanaj

  • 1Departments of Neurology (RK, LH, BJ, SLG, LJB) and Population Health (RK, ML, YC, LET, LJB), New York University Grossman School of Medicine, New York, New York; Al-Bahar Ophthalmology Center (AAA-H, RB), Ibn Sina Hospital, Kuwait City, Kuwait; Centre for Research on Sports in Society (LB), Mulier Institute, Utrecht, Netherlands; Experimental and Clinical Research Center (AUB, AP, FP, HZ), Max Delbrueck Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, Berlin, Germany; Department of Neurology (AUB), University of California, Irvine, California; Department of Neurology (PAC, SS), Johns Hopkins University, Baltimore, Maryland; Laboratory of Neuroimmunology (EMF, TF), Stanford University School of Medicine, Palo Alto, California; Institute of Clinical Neuroimmunology (JH), LMU Hospital, Ludwig Maximilians Universität München, Munich, Germany; Data Integration for Future Medicine consortium (DIFUTURE) (JH), Ludwig-Maximilians University, Munich, Germany; Department of Neurology (BH, BK, TK), Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany; Munich Cluster for Systems Neurology (SyNergy) (BH, TK), Munich, Germany; Department of Neurology (HJ), Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida; Vita-Salute University & Hospital San Raffaele (LL, MP), Milano, Italy; Center of Neuroimmunology and Department of Neurology (EHM-L, PV), Hospital Clinic of Barcelona, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain; Neurologic Clinic and Policlinic (AP), MS Center and Research Center for Clinical Neuroimmunology and Neuroscience (RCN2NB) Basel, University Hospital Basel and University of Basel, Basel, Switzerland; NeuroCure Clinical Research Center (FP, HZ), Charité-Universitätsmedizin Berlin, Berlin, Germany; Moorfields Eye Hospital (AP), London, United Kingdom ; The National Hospital for Neurology and Neurosurgery (AP), Queen Square, UCL Institute of Neurology, London, United Kingdom; Dutch Neuro-Ophthalmology Expertise Centre (AP), Amsterdam UMC, Amsterdam, the Netherlands; Oregon Health and Science University (HI), Portland, Oregon; Department of Ophthalmology (JSS, GW, SLG, LJB), New York University Grossman School of Medicine, New York, New York; Departments of Biomedical Engineering and Electrical and Computer Engineering (JSS), Tandon School of Engineering, New York University, Brooklyn, New York; Center for Neural Science (JSS), NYU, New York, New York; and Neuroscience Institute (JSS), NYU Langone Health, New York, New York.

Journal of Neuro-Ophthalmology : the Official Journal of the North American Neuro-Ophthalmology Society
|September 1, 2022
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Summary

Spectral-domain optical coherence tomography (SD-OCT) measurements of retinal nerve fiber layer (pRNFL) and ganglion cell complex (GCIPL) are not interchangeable between devices. Conversion equations are provided to pool data from Spectralis and Cirrus devices, with significant thinning observed after age 40.

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Area of Science:

  • Ophthalmology and neuroscience research.
  • Utilizes advanced imaging techniques for retinal layer analysis.

Background:

  • Spectral-domain optical coherence tomography (SD-OCT) measures retinal layers like pRNFL and GCIPL.
  • Pooling data from different SD-OCT devices (e.g., Spectralis, Cirrus) is common in multiple sclerosis (MS) research but problematic due to device-specific measurement variations.
  • Lack of standardized segmentation algorithms and normative data across diverse populations limits data comparability.

Purpose of the Study:

  • To develop conversion equations for pooling peripapillary retinal nerve fiber layer (pRNFL) and macular ganglion cell + inner plexiform layer (GCIPL) thickness measurements between Spectralis and Cirrus SD-OCT devices.
  • To establish normative values for pRNFL and GCIPL thickness in a large, international cohort of healthy controls, considering age, sex, and race/ethnicity.
  • To identify the age at which accelerated decline in these retinal layers occurs.

Main Methods:

  • An 11-site international collaboration (IMSVISUAL consortium) collected SD-OCT data from 546 healthy controls using Spectralis or Cirrus devices.
  • Conversion equations were derived using structural equation modeling with data from participants scanned on both devices.
  • Generalized estimating equation (GEE) models were used to determine normative values and evaluate the influence of age, sex, and race/ethnicity on pRNFL and GCIPL thickness.

Main Results:

  • Conversion equations were established: Cirrus pRNFL = -5.0 + (1.0 × Spectralis) and Cirrus GCIPL = -4.5 + (0.9 × Spectralis).
  • A significant decline in pRNFL (-2.4 μm/decade) and GCIPL (-1.4 μm/decade) thickness was observed after age 40.
  • Female participants showed slightly higher pRNFL thickness, but no significant associations were found between retinal thickness and sex or race/ethnicity.

Conclusions:

  • Conversion equations facilitate the pooling of pRNFL and GCIPL data from Spectralis and Cirrus SD-OCT devices, crucial for multi-center studies and situations lacking consistent segmentation algorithms.
  • Retinal layer thinning accelerates after age 40, highlighting the importance of age-adjusted normative data in clinical trials and observational studies.
  • While race/ethnicity did not show significant associations with retinal thickness in this cohort, further research may be warranted.