Comprehensive Three-Dimensional Analysis of the Neuroretinal Rim in Glaucoma Using High-Density Spectral-Domain Optical Coherence Tomography Volume Scans

Abstract

PurposeTo describe spectral-domain optical coherence tomography (OCT) methods for quantifying neuroretinal rim tissue in glaucoma and to compare these methods to the traditional retinal nerve fiber layer thickness diagnostic parameter.MethodsNeuroretinal rim parameters derived from three-dimensional (3D) volume scans were compared with the two-dimensional (2D) Spectralis retinal nerve fiber layer (RNFL) thickness scans for diagnostic capability. This study analyzed one eye per patient of 104 glaucoma patients and 58 healthy subjects. The shortest distances between the cup surface and the OCT-based disc margin were automatically calculated to determine the thickness and area of the minimum distance band (MDB) neuroretinal rim parameter. Traditional 150-μm reference surface–based rim parameters (volume, area, and thickness) were also calculated. The diagnostic capabilities of these five parameters were compared with RNFL thickness using the area under the receiver operating characteristic (AUROC) curves.ResultsThe MDB thickness had significantly higher diagnostic capability than the RNFL thickness in the nasal (0.913 vs. 0.818, P = 0.004) and temporal (0.922 vs. 0.858, P = 0.026) quadrants and the inferonasal (0.950 vs. 0.897, P = 0.011) and superonasal (0.933 vs. 0.868, P = 0.012) sectors. The MDB area and the three neuroretinal rim parameters based on the 150-μm reference surface had diagnostic capabilities similar to RNFL thickness.ConclusionsThe 3D MDB thickness had a high diagnostic capability for glaucoma and may be of significant clinical utility. It had higher diagnostic capability than the RNFL thickness in the nasal and temporal quadrants and the inferonasal and superonasal sectors.

Enhanced Diagnostic Capability for Glaucoma of 3-Dimensional Versus 2-Dimensional Neuroretinal Rim Parameters Using Spectral Domain Optical Coherence Tomography

“…The MDB thickness was calculated by measuring the shortest distances from 100 points along the RPE/BM complex to the cup surface (Figure 1D) and has been previously described in detail by our group in recent publications. 33,34 The BMO-MRW thickness was determined from the 24 radial B-scan protocol, using the Glaucoma Premium Module software (6.0.11) seen in Figure 3. The BMO-MRW is defined by the minimum distance between the Bruch’s Membrane Opening and the ILM.…”

A strategy for OCT estimation of the optic nerve head pigment epithelium central limit‐inner limit of the retina minimal distance, PIMD‐2π

“…; Tsikata et al. ). The low estimated coefficient of variation for PIMD‐2 π segmentations, 0.05, indicates that PIMD‐2 π can be estimated with high precision using few iterated segmentations.…”

“…) and the Spectralis device (Tsikata et al. ). The option to use radial capture scans provided by the Spectralis device has been used with either 24 (Reis et al.…”

“…A custom algorithm for segmentation of the Minimal Distance Band from a cube representation captured with the Spectralis device (Heidelberg, Germany) has been published (Tsikata et al. ; Fan et al. ).…”

Optical coherence tomography evaluation of the optic nerve head neuro‐retinal rim in glaucoma

“…It is likely that disc size has greater impact at the extremes, that is, for very small or very large discs or discs of highly myopic eyes . Other similar approaches based on minimum distance mapping have confirmed the advantages it provides for glaucoma diagnostics …”