Agreement of optical coherence tomography thickness measurements between Heidelberg Eye Explorer and ImageJ software



      To investigate the agreement and correlation of manual central foveal thickness (CFT) measurements using the Heidelberg Eye Explorer and ImageJ software.


      Optical coherence tomography (OCT) images were identified. CFT was measured using the Heidelberg Eye Explorer caliper tool. Two independent graders measured the CFT of the same images using ImageJ software. A Pearson correlation coefficient, intraclass correlation coefficient, Bland–Altman plots, and coefficient of repeatability were used to assess the agreement and correlation between the Heidelberg Eye Explorer and ImageJ measurements.


      One-hundred and twenty-two OCT images from 91 patients were analyzed. Mean CFT as measured using the Heidelberg caliper tool was 264.8 ± 113 µm. Using ImageJ software, graders 1 and 2 obtained mean CFT values of 267 ± 114.3 µm and 270 ± 114.8 µm, respectively. Pearson correlation revealed a strong correlation between the Heidelberg and Image J measurements (r = 0.999, p < 0.0001). Bland–Altman plots noted a less than 4 µm mean difference between Heidelberg and ImageJ CFT values (2.67 ± 3.46 and 3.72 ± 2.78 µm for graders 1 and 2, respectively).


      There was strong agreement between the Heidelberg Eye Explorer and ImageJ software for manual CFT measurements. ImageJ may be a reliable tool for thickness measurements when proprietary OCT software is unavailable.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Canadian Journal of Ophthalmology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Puliafito CA
        • Hee MR
        • Lin CP
        • et al.
        Imaging of macular diseases with optical coherence tomography.
        Ophthalmology. 1995; 102: 217-229
        • Wibbelsman TD
        • Pandit RR
        • Xu D
        • et al.
        Trends in retina specialist imaging utilization from 2012 to 2016 in the United States Medicare fee-for-service population.
        Am J Ophthalmol. 2019; 208: 12-18
        • Shah AR
        • Williams S
        • Baumal CR
        • Rosner B
        • Duker JS
        • Seddon JM.
        Predictors of response to intravitreal anti–vascular endothelial growth factor treatment of age-related macular degeneration.
        Am J Ophthalmol. 2016; 163 (154–66.e8)
        • Goebel W
        • Kretzchmar-Gross T.
        Retinal thickness in diabetic retinopathy: a study using optical coherence tomography (OCT).
        Retina. 2002; 22: 759-767
        • Furuta M
        • Iida T
        • Kishi S.
        Foveal thickness can predict visual outcome in patients with persistent central serous chorioretinopathy.
        Ophthalmologica. 2009; 223: 28-31
        • Kim J
        • Rhee KM
        • Woo SJ
        • Yu YS
        • Chung H
        • Park KH.
        Long-term temporal changes of macular thickness and visual outcome after vitrectomy for idiopathic epiretinal membrane.
        Am J Ophthalmol. 2010; 150 (701–9.e1)
        • Schneider CA
        • Rasband WS
        • Eliceiri KW.
        NIH image to ImageJ: 25 years of image analysis.
        Nat Methods. 2012; 9: 671-675
        • Shahlaee A
        • Pefkianaki M
        • Hsu J
        • Ho AC.
        Measurement of foveal avascular zone dimensions and its reliability in healthy eyes using optical coherence tomography angiography.
        Am J Ophthalmol. 2016; 161 (50–5.e1)
        • Busov B
        • Besirli CG.
        Optimization of ImageJ for automated image analysis to assess for photoreceptor cell death in retinal tissue sections.
        Invest Ophthalmol Vis Sci. 2014; 55: 4365
        • Maidana DE
        • Tsoka P
        • Tian B
        • et al.
        A novel ImageJ macro for automated cell death quantitation in the retina.
        Invest Ophthalmol Vis Sci. 2015; 56: 6701-6708
        • Abràmoff DMD
        • Magalhães PJ
        • Ram SJ.
        Image processing with ImageJ.
        Biophotonics Int. 2004; 11: 36-42
        • Staurenghi G
        • Sadda S
        • Chakravarthy U
        • Spaide RF.
        Proposed lexicon for anatomic landmarks in normal posterior segment spectral-domain optical coherence tomography: the IN·OCT consensus.
        Ophthalmology. 2014; 121: 1572-1578
        • Koo TK
        • Li MY.
        A guideline of selecting and reporting intraclass correlation coefficients for reliability research.
        J Chiropr Med. 2016; 15: 155-163
        • Krzystolik MG
        • Strauber SF
        • Aiello LP
        • et al.
        • Diabetic Retinopathy Clinical Research Network
        Reproducibility of macular thickness and volume using Zeiss optical coherence tomography in patients with diabetic macular edema.
        Ophthalmology. 2007; 114: 1520-1525
        • Sull AC
        • Vuong LN
        • Price LL
        • et al.
        Comparison of spectral/Fourier domain optical coherence tomography instruments for assessment of normal macular thickness.
        Retina. 2010; 30: 235
        • Sander B
        • Al-Abiji HA
        • Kofod M
        • Jørgensen TM.
        Do different spectral domain OCT hardwares measure the same? Comparison of retinal thickness using third-party software.
        Graefes Arch Clin Exp Ophthalmol. 2015; 253: 1915-1921
        • Gianniou C
        • Dirani A
        • Jang L
        • Mantel I.
        Refractory intraretinal or subretinal fluid in neovascular age-related macular degeneration treated with intravitreal ranizubimab: functional and structural outcome.
        Retina. 2015; 35: 1195-1201
        • Govetto A
        • Lalane RA
        • Sarraf D
        • Figueroa MS
        • Hubschman JP.
        Insights into epiretinal membranes: presence of ectopic inner foveal layers and a new optical coherence tomography staging scheme.
        Am J Ophthalmol. 2017; 175: 99-113
        • Sadda SR
        • Wu Z
        • Walsh AC
        • et al.
        Errors in retinal thickness measurements obtained by optical coherence tomography.
        Ophthalmology. 2006; 113: 285-293