Agreement between the Heidelberg Retina Tomograph and Discam when measuring various optic disc parameters

Velota CT Sung, Anna Bhan and Stephen A Vernon

Department of Ophthalmology, Queen's Medical Centre, University Hospital, Nottingham, UK

Purpose:  To assess the agreement between a digital stereo optic disc camera (Discam) and a Heidelberg Retina Tomograph (HRT) when measuring normal and glaucomatous optic discs.

Methods: The optic discs of 78 eyes of 39 persons (18 POAG, 7 NTG, 2 OH and 12 normal) were imaged with the Discam and the HRT. Two observers independently drew the disc margins on the HRT mean topography images and the disc and cup margins on the Discam images. The agreement between area cup-disc ratio (ACDR) and the radial cup-disc ratio (RCDR) at various angles were calculated using the intraclass correlation coefficient (ICC).

Results: 8 eyes were excluded due to poor image quality. ACDR agreement in 26 eyes with clinically normal optic discs was fair to substantial (ICC = 0.22 and 0.64, observer A and B respectively). RCDR agreement was poor in observer A (ICC = -0.01 to 0.1) and fair to moderate in observer B (ICC = 0.33 to 0.46). ACDR agreement from 44 eyes with glaucomatous excavation was moderate (ICC = 0.44 and 0.52, observer A and B respectively). RCDR agreement was poor to moderate in observer A (ICC = 0.2 to 0.47) and poor to substantial in observer B (ICC = 0.14 to 0.69).

Conclusion: The agreement ranged from fair to substantial for ACDR and poor to substantial for RCDR. There was substantial variation in the agreement from the two observers. Measurements derived from the HRT and the Discam do not appear to be interchangeable for clinical purposes.