Diagnostic capability of a linear discriminant function applied to a novel Spectralis OCT glaucoma-detection protocol

Abstract

Background: Bruch membrane opening-minimum rim width (BMO-MRW) assessment offers a new diagnostic use in glaucoma patients of the Glaucoma Module Premium Edition (GMPE) available for the Spectralis optical coherence tomography (OCT) system. The objective of our research was to evaluate the diagnostic benefits of examining BMO-MRW and peripapillary retinal nerve fibre layer (pRNFL) readings acquired with Spectralis OCT to distinguish between healthy and mild glaucoma patients, comparing those readings with the standard pRNFL application. Moreover, we investigated whether using a particular combination of BMO-MRW and pRNFL parameters with a linear discriminant function (LDF) could further enhance glaucoma diagnosis. Methods: One hundred thirty-six eyes from 136 individuals were incorporated into this observational, prospective cross-sectional study: 68 mild primary open-angle glaucoma (POAG) patients according to the Hodapp-Parrish-Anderson criteria (mean deviation between 0 and − 6 dB) and 68 healthy control subjects selected by Propensity Score Matching. MRW and pRNFL thickness around the disc (diameters: 3.5 mm, 4.1 mm, and 4.7 mm) were obtained using the BMO-MRW protocol, and pRNFL thickness at 3.5 mm was obtained with the standard glaucoma application. The group data were contrasted. One sample was chosen at random to develop the LDF (teaching set: 34 healthy subjects and 34 POAG patients) using a combination of MRW and pRNFL parameters (acquired with the BMO-MRW protocol); the other sample provided a test of how the LDF performed on an independent group (validating set: 34 healthy subjects and 34 POAG patients). The receiver operating curves (ROCs) were plotted for every measurement and contrasted with the proposed LDF. The OCT parameters with the best area under the receiver operating characteristic curve (AUC) were determined. Results: Global MRW and pRNFL thicknesses were significantly thinner in the POAG group (p < 0.001). The BMO-MRW parameters showed good diagnostic accuracy; the largest AUCs reached 0.875 for the LDF and 0.879 for global RNFL thickness using the standard glaucoma application. There were no statistical differences between the AUCs calculated. Conclusions: BMO-MRW parameters show a strong capability to differentiate between mild glaucoma and control eyes. Our LDF based on the new BMO-MRW OCT protocol did not perform better than isolated parameters.

Clinical-Evolutionary Staging System of Primary Open-Angle Glaucoma Using Optical Coherence Tomography

“…In contrast, Chauhan et al [30], Enders et al [31] and Malik et al [32] proved that BMO-MRW showed higher diagnostic ability compared to peripapillary RNFL. Bambo et al [33] did not find any differences between diagnostic ability of peripapillary RNFL and BMO-MRW in glaucoma. In the present study, we integrated both strategies to achieve a better model.…”

Porównanie czułości metod BMO-MRW, GCC, ONH i RNFL w diagnostyce i ocenie leczenia jaskry młodzieńczej

“…Studies by many authors have shown that changes in BMO-MRW occur earlier than changes in RNFL in patients with open-angle glaucoma [6,8,[10][11][12][13]. In other clinical studies, it has been found that the results of the assessment of the thickness of the layer of retinal nerve fibers with BMO-MRW and RNFL are comparable in patients with glaucoma [7,15,16] and in healthy subjects [17]. It has also been shown that BMO-MRW assesses the condition of the optic nerve better than ONH in patients with glaucoma and in healthy patients [11].…”

“…Measurements are made in radial scans of various meridians of the optic nerve disc. Clinical studies have shown that BMO-MRW is an objective and valuable diagnostic tool for assessing the degree of damage to the nerve fibers of the retina on the optic nerve disc [5][6][7][8][9][10][11][12][13][14][15][16][17]. Many studies have found that BMO-MRW is a more sensitive and specific parameter of the glaucomatous damage to the optic disc than the visual field, ONH and RNFL [5][6][7][8][9][10][11][12][13][14][15][16][17].…”

“…Clinical studies have shown that BMO-MRW is an objective and valuable diagnostic tool for assessing the degree of damage to the nerve fibers of the retina on the optic nerve disc [5][6][7][8][9][10][11][12][13][14][15][16][17]. Many studies have found that BMO-MRW is a more sensitive and specific parameter of the glaucomatous damage to the optic disc than the visual field, ONH and RNFL [5][6][7][8][9][10][11][12][13][14][15][16][17]. The aim of this paper is to compare the sensitivity of the BMO-MRW method with other methods used for the assessment of damage to retinal nerve fibers in patients with juvenile glaucoma.…”

Impact of Epiretinal Membrane on Optical Coherence Tomography Tools Used for Monitoring Glaucoma

“…All OCT scans were acquired using the Glaucoma Module Premium Edition, which offers scan patterns and an updated reference database [ 17 ]. This module includes the patented Anatomic Positioning System.…”