Diagnostic ability of retinal nerve fiber layer maps to detect localized retinal nerve fiber layer defects

Abstract

Purpose To evaluate and compare the diagnostic ability of spectral domain optical coherence tomography (SD-OCT) for detecting localized retinal nerve fiber layer (RNFL) defects in topographic RNFL maps and circumpapillary RNFL (cpRNFL) thickness measurements. Methods Sixty-four eyes with localized RNFL defects in red-free RNFL photographs and 72 healthy eyes were included. All participants were imaged with SD-OCT. The area and angular width of the localized RNFL defects were measured with ImageJ software on RNFL thickness map, significance map (yellow pixels, o5% level), and red-free RNFL photographs. The sensitivity, specificity, and area under the receiver operating characteristic curves (AUCs) were calculated for cpRNFL thickness, macular inner retina thickness, and RNFL maps (thickness, significance) according to the quantitative measurements and a o5% level of classification to distinguish eyes with localized RNFL defects from healthy eyes. Results RNFL thickness map (sensitivity 96.9-98.4%, specificity 86.1-98.6%, and AUCs 0.915-0.992) and significance map (sensitivity 96.9-98.4%, specificity 88.9-95.8%, and AUCs 0.937-0.983) showed superior performance in detecting localized RNFL defects compared with other parameters (P-value 0.001-0.024) except for 36 sector cpRNFL thickness (sensitivity 92.2%, specificity 87.5%, and AUCs 0.898; P-value 0.080-0.545). The sensitivity for detecting RNFL defects was related to the angular width, area, and depth of the RNFL defects in the cpRNFL (4 sector, 12 sector) and macular inner retinal measurements. RNFL thickness and significance maps showed a constant sensitivity regardless of variations in angular width, area, and depth of the RNFL defects. Conclusion RNFL thickness and significance maps could be used to distinguish eyes with localized RNFL defects from healthy eyes more effectively than cpRNFL thickness and macular inner retina thickness measurements.

Diagnostic Ability of Retinal Nerve Fiber Layer Thickness Deviation Map for Localized and Diffuse Retinal Nerve Fiber Layer Defects

“…Several previous studies have reported similar results, finding that the RNFL deviation map significantly improves the diagnostic sensitivity for localized RNFL defects or glaucoma detection compared with conventional circumpapillary RNFL measurement [4, 14, 16]. A broader imaging area of SD-OCT provides a greater chance to find signs of RNFL damage.…”

“…The best circumpapillary RNFL parameter was inferior RNFL thickness (0.914) in the localized RNFL defect group, and average RNFL thickness (0.986) in the diffuse RNFL defect group. Table 4 presents a number of previous studies on the diagnostic ability of circumpapillary RNFL thickness in glaucoma patients [4, 14–22]. In the studies of localized RNFL defects, sectoral RNFL measurements (clock-hour or inferior quadrant) were the most useful parameters [14–17].…”

“… Table 4 presents a number of previous studies on the diagnostic ability of circumpapillary RNFL thickness in glaucoma patients [4, 14–22]. In the studies of localized RNFL defects, sectoral RNFL measurements (clock-hour or inferior quadrant) were the most useful parameters [14–17]. On the other hand, in the studies that did not classify defects as localized or diffuse type, average RNFL thickness showed a relatively improved diagnostic ability [4, 18–22].…”

Diagnostic Capability of Peripapillary Three-dimensional Retinal Nerve Fiber Layer Volume for Glaucoma Using Optical Coherence Tomography Volume Scans

“…Previous reports have shown that localized and diffuse defects in glaucoma predominantly affect the inferior quadrant. 16,44 In moderate to advanced glaucoma, localized RNFL defects constitute 4.2% of the defects, whereas 94.5% demonstrate diffuse defects. In addition to that, diffuse RNFL defects are located closer to the optic disc than localized RNFL defects.…”

Assessment of macular ganglion cell complex using optical coherence tomography: Impact of a paediatric reference database in clinical practice

“…30 After comparing our study results with those of previous studies performed with the same Topcon OCT device but in adults, we found similar mRNFL values, although GCL-IPL values were thicker in paediatric patients. In their investigations in adults, Shin et al 31 and Kim et al 32 found, respectively, the following values: superior mRNFL, 33.9 AE 5.0 μm and 34.81 AE 3.93 μm; inferior mRNFL, 37.3 AE 4.7 μm and 37.89 AE 4.38 μm; total mRNFL, 35.5 AE 4.4 μm and 36.32 AE 3.75 μm; superior GCL-IPL, 71.4 AE 6.0 μm and 71.57 AE 5.37 μm; inferior GCL-IPL, 70.1 AE 5.9 μm and 69.49 AE 5.15 μm; and total GCL-IPL, 70.8 AE 5.1 μm and 70.49 AE 5.04 μm. As GCL-IPL tends to be thicker in children than in adults, the main difference between adult and paediatric GCL-IPL categories is an overdiagnosis of normality when using the adult database.…”