Agreement between structural parameters provided by the swept-source OCT and Laguna ONhE

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Abstract
Purpose: To evaluate the agreement between optic nerve head structural parameters obtained using swept-source optical coherence tomography and the Laguna ONhE software. Methods: This retrospective cross-sectional study included 353 eyes from healthy individuals, glaucoma suspects, ocular hypertensive patients, and patients with glaucoma. Optic nerve head parameters—including disc area, vertical and area cup-to-disc ratios, and rim volume—were measured using swept-source optical coherence tomography and Laguna ONhE. Agreement between methods was assessed using Bland–Altman analysis. A regression-based calibration model was developed for disc area measurements. Results: Laguna ONhE systematically underestimated disc area (p < 0.001) and cup-to-disc ratios (p<0.001) and overestimated rim volume (p=0.0002) compared with swept-source optical coherence tomography. After applying the calibration equation for disc area, agreement improved substantially, with no statistically significant bias (p=0.3). Conclusion: Laguna ONhE provides structural estimates comparable with those obtained with swept-source optical coherence tomography after calibration, suggesting it may serve as a practical and cost-effective alternative for glaucoma evaluation.