Purpose To evaluate the reproducibility of peri-papillary retinal nerve fiber layer (RNFL) thickness measurements obtained by Spectralis spectral domain optical coherence tomography (OCT) (Heidelberg Engineering, Heidelberg, Germany) in normal and glaucoma subjects. Methods Participants were recruited from a university-based clinic. Peri-papillary RNFL thickness measurements were repeated three times during the same visit using the follow-up function. One eye of each participant was randomly selected for statistical analysis. Reproducibility was evaluated using within-subject standard deviation (Sw), coefficient of variation (CV), and intraclass correlation coefficient (ICC). Spearman’s rank correlation coefficient analyses were used to assess the correlation of the standard deviation of the 3 measurements for each participant with the RNFL thickness value. Results Forty-five normal subjects and 33 glaucoma patients were included in the study. The CVs ranged from 1.45% [overall global (G)] to 2.59% [temporal quadrant (T)] in normal eyes and from 1.74% (G) to 3.22% (T) in glaucomatous eyes. ICCs ranged from 0.977 (T) to 0.990 (G and inferior-nasal sector) in normal eyes and from 0.983 (T) to 0.997 (inferior quadrant) in glaucomatous eyes. Sw were from 1.34μm (G) to 2.39μm (superior-temporal and inferior-temporal sectors) in normal eyes and from 1.14μm (G) to 2.25μm (superior-nasal sector) in glaucomatous eyes. There were no significant correlations between RNFL thickness values and measurement variability for each participant. Conclusions Spectralis OCT shows excellent reproducibility for measuring peri-papillary RNFL thickness values in both healthy and glaucoma subjects.

Purpose To determine the diagnostic capability of spectral domain optical coherence tomography (OCT) in glaucoma patients with visual field (VF) defects. Design Prospective, cross-sectional study. Methods Setting Participants were recruited from a university hospital clinic. Study Population One eye of 85 normal subjects and 61 glaucoma patients [with average VF mean deviation (MD) of -9.61 ± 8.76 dB] were randomly selected for the study. A subgroup of the glaucoma patients with early VF defects was calculated separately. Observation Procedures Spectralis OCT circular scans were performed to obtain peripapillary retinal nerve fiber layer (RNFL) thicknesses. The RNFL diagnostic parameters based on the normative database were used alone or in combination for identifying glaucomatous RNFL thinning. Main Outcome Measures To evaluate diagnostic performance, calculations included areas under the receiver operating characteristic curve (AROC), sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio. Results Overall RNFL thickness had the highest AROC value (0.952 for all patients, 0.895 for the early glaucoma subgroup). For all patients, the highest sensitivity (98.4%, CI 96.3-100%) was achieved by using two criteria: ≥1 RNFL sectors being abnormal at the < 5% level, and overall classification of borderline or outside normal limits, with specificities of 88.9% (CI 84.0-94.0%) and 87.1% (CI 81.6-92.5%) respectively for these two criteria. Conclusions Statistical parameters for evaluating the diagnostic performance of the Spectralis spectral domain OCT were good for early perimetric glaucoma and excellent for moderately-advanced perimetric glaucoma.

BackgroundTo present a comprehensive approach for the management of patients with neovascular glaucoma (NVG) aiming to preserve visual function and complement pan-retinal photocoagulation (PRP) by anti-vascular endothelial growth factor (anti-VEGF) treatment and anti-glaucoma surgery.MethodsThis study includes a prospective, interventional case series. A process flow chart for NVG management was designed. Totally 50 patients (51 eyes) with NVG were included. Of these, 43 patients (44 eyes) completed the treatment process. Patients were divided into central retinal vein occlusion (CRVO) and proliferative diabetic retinopathy (PDR) groups according to their original diagnosis. Intraocular pressure (IOP), visual function, and the status of iris and angle neovascularization were recorded before and after treatment.ResultsPatients were followed up for 6–30 months (mean 12.2 months). The IOP of all 44 patients was effectively controlled and was significantly less after treatment (16.68 ± 4.69 mmHg) than before treatment (42.59 ± 9.44 mmHg, P < 0.05). Thirty-nine eyes displayed controlled IOP (≤21 mmHg) after treatment. Visual acuity improved, to some extent, in 32 eyes (72.9 %), and 12 eyes (27.3 %) had a visual acuity better than 0.1. There was no significant difference in IOP between the PDR and CRVO groups at the end of follow-up (P = 0.8657), but the visual acuity in the PDR group was much better than that in the CRVO group (P = 0.0079).ConclusionsA comprehensive therapy for NVG can effectively control IOP and preserve visual function in patients by anti-VEGF injection and anti-glaucoma surgery.