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Deanna Cettomai, BS; Mathew Pulicken, MBBS, MHS; Eliza Gordon-Lipkin, BS; Amber Salter, MPH; Teresa C. Frohman, BA; Amy Conger, BA; Xiao Zhang, PhD; Gary Cutter, PhD; Laura J. Balcer, MD, MSCE; Elliot M. Frohman, MD, PhD; Peter A. Calabresi, MD

Arch Neurol. 2008;65(9):1218-1222.

Background  Optical coherence tomography (OCT) is a promising new method of quantifying axon thickness in the retinal nerve fiber layer (RNFL) that has been used predominantly by ophthalmologists to monitor glaucoma. Optical coherence tomography is being considered as a potential outcome measure in multiple sclerosis (MS) clinical trials, but no data exist on the reproducibility of this technique in MS centers.

Objective  To determine the reproducibility of OCT measurement of mean RNFL thickness in the undilated eyes of healthy control subjects and patients with MS.

Design  Prospective analysis of 4 healthy controls to determine interrater, intrarater, and longitudinal reproducibility. Cross-sectional analysis of 3 cohorts of patients with MS (n = 396) and healthy controls (n = 153).

Setting  Multiple sclerosis clinics at 3 academic medical centers.

Patients or Other Participants  Healthy controls and patients with MS.

Main Outcome Measure  Thickness of RNFL.

Results  We found excellent agreement with respect to interrater (intraclass correlation [ICC], 0.89), intrarater (ICC, 0.98), and intervisit (ICC, 0.91) results. Mean RNFL thickness did not vary significantly among research centers for patients with MS (93, 92, and 90 µm) or among healthy controls (103, 105, and 104 µm) by site.

Conclusions  We demonstrate that mean RNFL thickness can be reproducibly measured by trained technicians in an MS center using the OCT-3 model. The RNFL measures from cohorts of age-matched controls and patients with MS from 3 different research centers were remarkably similar.

Author Affiliations: Department of Neurology, The Johns Hopkins School of Medicine, Baltimore, Maryland (Mss Cettomai and Gordon-Lipkin and Drs Pulicken and Calabresi); Departments of Neurology and Ophthalmology, The University of Texas Southwestern Medical Center, Dallas (Mss Salter, Frohman, and Conger and Dr Frohman); Department of Biostatistics, University of Alabama, Birmingham (Drs Zhang and Cutter); and Departments of Neurology and Ophthalmology, University of Pennsylvania School of Medicine, Philadelphia (Dr Balcer).

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