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Comparison of the Clinical Disc Margin Seen in Stereo Disc Photographs With Neural Canal Opening Seen in Optical Coherence Tomography Images

Young, Mei MASc*; Lee, Sieun BASc*; Rateb, Mahmoud MD; Beg, Mirza F. PhD*; Sarunic, Marinko V. PhD*; Mackenzie, Paul J. MD, PhD

doi: 10.1097/IJG.0b013e31829484a4
Original Studies

Purpose: To compare neural canal opening (NCO) with the clinical optic disc margin (DM) seen and to investigate the planarity of the NCO in normal human optic nerve heads (ONH).

Methods: Sixteen eyes were imaged. Twelve healthy eyes were selected for planarity and 9 for NCO and DM correspondence. All subjects were subjected to a visual field examination, stereo disc photograph (SDP), scanning laser ophthalmoscopy, clinical examination with a fellowship trained glaucoma specialist, and optical coherence tomography imaging. Three reviewers delineated the NCO and inner limiting membrane on optical coherence tomography images. The clinical DM was delineated by a glaucoma specialist while viewing SDPs. Plane error was calculated for NCO and for Bruch membrane (BM) at distances 80 and 120 μm from NCO.

Results: The NCO segmentation interrater variability was low with an average coefficient of variation of 2.7%. A regional variation of the SDP and NCO correspondence was observed, wherein the temporal region had the largest coefficient of variation. The plane error of the NCO and BM were similar and was approximately 12 μm, which is small relative to an average DM diameter of 1.7 mm.

Conclusions: The BM opening has a good correspondence with the clinical DM seen in SDPs. NCO delineation seemed to be reliable. The BM and NCO are relatively planar in normal humans and can be further evaluated for longitudinal studies to observe stability.

*School of Engineering Science, Simon Fraser University

Department of Ophthalmology and Visual Sciences, University of British Columbia, BC, Canada

Funded by Michael Smith Foundation for Health Research (MSFHR) (to M.V.S. and M.F.B.), Natural Sciences and Engineering Research Council (NSERC) of Canada (to M.Y.).

Disclosure: The authors declare no conflict of interest.

Reprints: Mei Young, MASc, School of Engineering Science, Simon Fraser University, 8888 University Drive, Burnaby, BC, Canada V6Z 2NZ (e-mail:

Received July 15, 2012

Accepted December 3, 2012

© 2014 by Lippincott Williams & Wilkins.