SCIENTIFIC REPORT Improving the repeatability of Heidelberg retina tomograph and Heidelberg retina tomograph II rim area measurements

Aims: To devise and test strategies for improving Heidelberg retina tomograph (HRT and HRT-II) rim area (RA) repeatability and assess the benefit of the strategies in time series of HRT images. Methods: The effect of the standard and 320 mm reference planes and image quality on RA repeatability was assessed in a test-retest HRT image dataset from 74 subjects. A longitudinal HRT image dataset from 30 ocular hypertensive subjects was analysed by linear regression of RA over time, with each of the reference planes and using a manual image alignment facility. RA variability was estimated by comparing the standard deviation of residuals (RSD) generated by each linear regression. Results: RA repeatability was better with the 320 mm reference plane (repeatability coefficient 0.17 mm), improving further with only good quality images (repeatability coefficient 0.08 mm). For the longitudinal data, a significant (p,0.0001) reduction in the RSD from 0.10 to 0.05 mm was obtained with the 320 mm reference plane. Manual alignment led to a further significant (p,0.0001) reduction in the RSD to 0.04 mm. Conclusions: The findings support the use of a 320 mm reference plane and manual image alignment to analyse RA over time. The estimates of RA repeatability may be used to define thresholds for glaucomatous change.