Repeatability of Choroidal Thickness Measurements in Healthy Subjects using RTVue XR Optical Coherence Tomography

PURPOSE: To determine the intrasession, intraobserver, interobserver, and repeatability of choroidal thickness measurements in the healthy subjects imaged on enhanced depth imaging system of RTVue XR spectral domain optical coherence tomography (OCT). METHODS: In this prospective, cross-sectional study, seventy eyes of 70 healthy volunteers with no known ocular disease were imaged using high-density scanning protocol of RTVue XR OCT. In a single imaging session, three sequential 12 mm macular-enhanced depth horizontal line scans were obtained through the fovea. Two experienced examiners measured the subfoveal choroidal thickness (SFCT), choroidal thickness at 500 μm nasally and temporally from the fovea in all the eyes, using the manual calipers provided in the software. The graders were masked to each other's measurement readings. The coefficient of repeatability (CR) and intraclass correlation coefficient (ICC) were used to measure the reliability within graders. Intergrader variability was assessed using Bland-Altman method and 95% limits of agreement (LoA). RESULTS: Intragrader CR for grader one was 4.11 μm (95% confidence interval [CI], −2.84–11.06) for SFCT and 5.73 μm (95% CI, −3.71–15.16) for the grader two. Intragrader ICC of grader one ranged from 0.996 for SFCT to 0.994 for temporal choroidal thickness. Intragrader ICC of grader two ranged from 0.993 for temporal choroidal thickness to 0.991 for SFCT. Intergrader CR ranged from 5.24 μm (95% CI, −4.66–15.15) for SFCT to 5.89 μm (95% CI, −7.27–19.04) for temporal choroidal thickness. Intergrader 95% LoA for SFCT, nasal and temporal choroidal thickness were, −15.84–12.15 μm, −15.99–17.7 μm, and − 19.12–15.57 μm, respectively. CONCLUSION: Choroidal thickness measurements can be quantified with good repeatability using RTVue XR OCT, which would be useful in patients with chorioretinal diseases.