Piedrahita-Alonso Elena, López-Redondo Estela, Valverde-Megías Alicia, Felipe-Márquez Gema, Martín-García Beatriz, Gomez-de-Liano Rosario
From the Faculty of Optics and Optometry, Complutense University of Madrid, Madrid, Spain (E-P.A., E.L-R., B.M-G., R.G-L.).
From the Faculty of Optics and Optometry, Complutense University of Madrid, Madrid, Spain (E-P.A., E.L-R., B.M-G., R.G-L.).
Am J Ophthalmol. 2025 Jan;269:273-281. doi: 10.1016/j.ajo.2024.08.004. Epub 2024 Aug 6.
Torsional eye position by the disc-fovea angle (DFA) is a relevant objective parameter in vertical strabismus. DFA measurement with optical coherence tomography (OCT) has proven to be a good alternative to the gold standard measurement in fundus photography. Our study aims to analyze the validity and reliability of 2 undescribed Cirrus high-definition OCT (HD-OCT; Carl Zeiss Meditec) methods that offer clinical advantages for measuring objective cycloposition in normal patients compared with Spectralis spectral-domain OCT (Heidelberg Engineering) and the reference method.
Prospective validity and reliability analysis.
Objective cycloposition by means of the DFA was measured in the right eyes of 59 binocularly normal individuals attending the ophthalmology service of a medical institution. DFA was obtained by fundus photography (gold standard), FoDi software of Spectralis spectral-domain OCT, HD 1 line scan of Cirrus HD-OCT, and macular cube of Cirrus HD-OCT (fundus, FoDi, line, and cube methods, respectively). Measurements were performed 3 times for each method and the patient was repositioned and realigned between captures. Posterior manual quantification was made by 2 observers with external protractor software for the fundus and cube methods.
The 3 OCT methods showed and excellent agreement with fundus photography (ICC 0.83-0.84) with no significant differences comparing mean values (P = .36 for fundus-FoDi, P = .09 for fundus-line, and P = .09 for fundus-cube). Absolute differences between methods were 1.5°. All methods showed excellent reliability (ICC 0.92 for FoDi, 0.91 for line, 0.92 for cube, and 0.91 for fundus). The minimal detectable change was lower than 3° and the absolute difference between repeated measurements was 1° for all methods. Interrater reliability was excellent for methods requiring manual quantification (ICC 0.98 for cube, ICC 0.94 for fundus).
Measurement of the DFA by Cirrus HD-OCT methods in normal patients was a valid and reliable alternative for the cycloposition assessment. Among the methods, the Cirrus OCT HD 1 line improved clinical performance due to the simplicity and speed of measurement, with no need to export the image for quantification.
通过视盘 - 黄斑中心凹夹角（DFA）测量的扭转眼位是垂直斜视中的一个相关客观参数。光学相干断层扫描（OCT）测量DFA已被证明是眼底照相金标准测量的良好替代方法。我们的研究旨在分析两种未描述的Cirrus高清OCT（HD - OCT；卡尔·蔡司医疗技术公司）方法的有效性和可靠性，与Spectralis光谱域OCT（海德堡工程公司）和参考方法相比，这两种方法在测量正常患者的客观旋转眼位方面具有临床优势。
前瞻性有效性和可靠性分析。
在一家医疗机构眼科就诊的59名双眼正常个体的右眼，通过DFA测量客观旋转眼位。DFA通过眼底照相（金标准）、Spectralis光谱域OCT的FoDi软件、Cirrus HD - OCT的HD 1线扫描以及Cirrus HD - OCT的黄斑立方体扫描（分别为眼底、FoDi、线和立方体方法）获得。每种方法进行3次测量，每次测量之间患者重新定位并重新对齐。对于眼底和立方体方法，由2名观察者使用外部量角器软件进行后期手动定量分析。
三种OCT方法与眼底照相显示出极好的一致性（组内相关系数ICC为0.83 - 0.84），比较平均值时无显著差异（眼底 - FoDi比较，P = 0.36；眼底 - 线比较，P = 0.09；眼底 - 立方体比较，P = 0.09）。各方法之间的绝对差异为1.5°。所有方法均显示出极好的可靠性（FoDi的ICC为0.92，线的ICC为0.91，立方体的ICC为0.92，眼底的ICC为0.91）。所有方法的最小可检测变化低于3°，重复测量之间的绝对差异为1°。对于需要手动定量分析的方法，观察者间可靠性极好（立方体的ICC为0.98，眼底的ICC为0.94）。
Cirrus HD - OCT方法测量正常患者的DFA是旋转眼位评估的有效且可靠的替代方法。在这些方法中，Cirrus OCT HD 1线扫描因测量简单、速度快且无需导出图像进行定量分析而改善了临床性能。
