Evaluating the clinical relevance and reliability of outer retinal band length on optical coherence tomography in retinal disease: a cross-sectional study
Objectives Hyper-reflective outer retinal band (HORB) disruptions are reported across a range of retinal disease, yet a reliable, easily implemented assessment method and thorough evaluation of their association to retinal disease is lacking. The purpose of the study was to assess the reliability of...
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BMJ Publishing Group
2023-12-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/13/12/e077874.full |
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| author | Angelica Ly Michael Kalloniatis Rene Cheung Henrietta Wang Lisa Nivison-Smith |
| author_facet | Angelica Ly Michael Kalloniatis Rene Cheung Henrietta Wang Lisa Nivison-Smith |
| author_sort | Angelica Ly |
| collection | DOAJ |
| description | Objectives Hyper-reflective outer retinal band (HORB) disruptions are reported across a range of retinal disease, yet a reliable, easily implemented assessment method and thorough evaluation of their association to retinal disease is lacking. The purpose of the study was to assess the reliability of using magnitude estimation to evaluate HORB length and determine its association to visual acuity and retinal disease.Design Cross-sectional, retrospective study.Setting Patients attending a secondary eye care clinic in Sydney, Australia.Participants 2039 unique consecutive patients were screened for inclusion between 2 November and 18 January 2021, and 600 were included in the study population. Patients were included if they were referred from primary care, presented for an initial, comprehensive eye examination during the study period, imaged with optical coherence tomography during their visit and over 18 years of age.Primary outcome Reliability of HORB length estimations and associations to clinical outcomes.Results Intragrader (intraclass correlation coefficient, ICCfovea=0.81; ICCworst=0.91) and intergrader (ICCfovea=0.78–0.79; ICCworst=0.75–0.88) agreement of HORB length was good to excellent. HORB length was significantly associated with age (p<0.001, β=−0.22 to –0.24) and refractive error (p<0.001, β=0.12–0.16) at all B-scan locations. Visual acuity (p=0.001, β=−0.13) was associated with the primary outcome for foveal B-scans and eccentricity (p=0.002, β=−0.13) and device type (p=0.002, β=0.13) for non-foveal B-scans. Glaucoma was associated with HORB length on univariate analysis (p=0.05–0.06, β=−0.08); however, multivariate analysis revealed no significant association between HORB length and retinal disease.Conclusion HORB length is reliably assessed using magnitude estimation and may be useful as a surrogate biomarker of visual acuity. Several factors affect HORB length estimations, which may contribute to the lack of association to retinal disease and highlights the need for covariable adjustment when examining HORB disruptions. |
| format | Article |
| id | doaj-art-7de9ca64ee8047f0a541bd3bca57cf38 |
| institution | OA Journals |
| issn | 2044-6055 |
| language | English |
| publishDate | 2023-12-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-7de9ca64ee8047f0a541bd3bca57cf382025-08-20T01:48:37ZengBMJ Publishing GroupBMJ Open2044-60552023-12-01131210.1136/bmjopen-2023-077874Evaluating the clinical relevance and reliability of outer retinal band length on optical coherence tomography in retinal disease: a cross-sectional studyAngelica Ly0Michael Kalloniatis1Rene Cheung2Henrietta Wang3Lisa Nivison-Smith4School of Optometry and Vision Science, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, AustraliaCentre for Eye Health, Sydney, New South Wales, AustraliaSchool of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, AustraliaCentre for Eye Health, University of New South Wales, Sydney, New South Wales, AustraliaSchool of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, AustraliaObjectives Hyper-reflective outer retinal band (HORB) disruptions are reported across a range of retinal disease, yet a reliable, easily implemented assessment method and thorough evaluation of their association to retinal disease is lacking. The purpose of the study was to assess the reliability of using magnitude estimation to evaluate HORB length and determine its association to visual acuity and retinal disease.Design Cross-sectional, retrospective study.Setting Patients attending a secondary eye care clinic in Sydney, Australia.Participants 2039 unique consecutive patients were screened for inclusion between 2 November and 18 January 2021, and 600 were included in the study population. Patients were included if they were referred from primary care, presented for an initial, comprehensive eye examination during the study period, imaged with optical coherence tomography during their visit and over 18 years of age.Primary outcome Reliability of HORB length estimations and associations to clinical outcomes.Results Intragrader (intraclass correlation coefficient, ICCfovea=0.81; ICCworst=0.91) and intergrader (ICCfovea=0.78–0.79; ICCworst=0.75–0.88) agreement of HORB length was good to excellent. HORB length was significantly associated with age (p<0.001, β=−0.22 to –0.24) and refractive error (p<0.001, β=0.12–0.16) at all B-scan locations. Visual acuity (p=0.001, β=−0.13) was associated with the primary outcome for foveal B-scans and eccentricity (p=0.002, β=−0.13) and device type (p=0.002, β=0.13) for non-foveal B-scans. Glaucoma was associated with HORB length on univariate analysis (p=0.05–0.06, β=−0.08); however, multivariate analysis revealed no significant association between HORB length and retinal disease.Conclusion HORB length is reliably assessed using magnitude estimation and may be useful as a surrogate biomarker of visual acuity. Several factors affect HORB length estimations, which may contribute to the lack of association to retinal disease and highlights the need for covariable adjustment when examining HORB disruptions.https://bmjopen.bmj.com/content/13/12/e077874.full |
| spellingShingle | Angelica Ly Michael Kalloniatis Rene Cheung Henrietta Wang Lisa Nivison-Smith Evaluating the clinical relevance and reliability of outer retinal band length on optical coherence tomography in retinal disease: a cross-sectional study BMJ Open |
| title | Evaluating the clinical relevance and reliability of outer retinal band length on optical coherence tomography in retinal disease: a cross-sectional study |
| title_full | Evaluating the clinical relevance and reliability of outer retinal band length on optical coherence tomography in retinal disease: a cross-sectional study |
| title_fullStr | Evaluating the clinical relevance and reliability of outer retinal band length on optical coherence tomography in retinal disease: a cross-sectional study |
| title_full_unstemmed | Evaluating the clinical relevance and reliability of outer retinal band length on optical coherence tomography in retinal disease: a cross-sectional study |
| title_short | Evaluating the clinical relevance and reliability of outer retinal band length on optical coherence tomography in retinal disease: a cross-sectional study |
| title_sort | evaluating the clinical relevance and reliability of outer retinal band length on optical coherence tomography in retinal disease a cross sectional study |
| url | https://bmjopen.bmj.com/content/13/12/e077874.full |
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