Discriminating Between Normal and Glaucomatous Eyes Using the Heidelberg Retina Tomograph, GDx Nerve Fiber Analyzer, and Optical Coherence Tomograph

Abstract

Objective: To compare the ability of 3 instruments, the Heidelberg Retina Tomograph (HRT), the GDx Nerve Fiber Analyzer (GDx), and the Optical Coherence Tomograph (OCT), to discriminate between healthy eyes and eyes with early to moderate glaucomatous visual field loss. Subjects and Methods: Forty-one patients with early to moderate glaucomatous visual field loss and 50 healthy subjects were included in the study. The HRT, GDx, and OCT imaging and visual field testing were completed on 1 eye from each subject within a 6-month interval. Statistical differences in sensitivity at fixed specificities of 85%, 90%, and 95% were evaluated. In addition, areas under the receiver operating characteristic (ROC) curve were compared. Results: No significant differences were found between the area under the ROC curve and the best parameter from each instrument: OCT thickness at the 5-o'clock inferior temporal position (mean ± SE, 0.87 ± 0.04), HRT mean height contour in the nasal inferior region (mean±SE, 0.86 ± 0.04), and GDx linear discriminant function (mean±SE, 0.84±0.04). Twelve HRT, 2 GDx, and 9 OCT parameters had an area under the ROC curve of at least 0.81. At a fixed specificity of 90%, significant differences were found between the sensitivity of OCT thickness at the 5-o'clock inferior temporal position (71%) and parameters with sensitivities less than 52%. Qualitative assessment of stereophotographs resulted in a sensitivity of 80%. Conclusion: Although the area under the ROC curves was similar among the best parameters from each instrument, qualitative assessment of stereophotographs and measurements from the OCT and HRT generally had higher sensitivities than measurements from the GDx.

Changes in retinal nerve fiber layer and optic disc algorithms by optical coherence tomography in glaucomatous Arab subjects

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Changes in retinal nerve fiber layer and optic disc algorithms by optical coherence tomography in glaucomatous Arab subjects

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Stratus-OCT imaging in early glaucomatous and in ocular hypertensive patients with and without frequency-doubling technology abnormalities

“…These results are in agreement with several studies that showed that both previous OCT versions, 12,[21][22][23][24][25] and the current Stratus-OCT 26-28 perform well in discriminating glaucomatous eyes with early SAP defects from control eyes. On the other hand, studies have shown that OCT and SAP do not correlate so well in glaucoma suspects defined as eyes with suspicious optic disc cupping and normal SAP.…”

Glaucoma Detection Ability of Ganglion Cell-Inner Plexiform Layer Thickness by Spectral-Domain Optical Coherence Tomography in High Myopia

“…15,16,[40][41][42] Moreover, in those investigations, inferior RNFL thickness often demonstrated the best ability for discriminating normal eyes from glaucoma, with sensitivities between 38% and 82% for specificities of 90% or higher. 15,[40][41][42][43][44][45][46][47] And in other previous studies, macular GCIPL thickness showed AUROC of 0.64 to 0.99, with sensitivities ranging from 60% to 95%, 15,16 which are results similar to those reported here for the present study. In our study, the best SD-OCT (Carl Zeiss Meditec) parameters with the largest AUROC were inferior RNFL thickness (AUROC ¼ 0.906); the 7-o'clock sector (AUROC ¼ 0.840); and the inferotemporal GCIPL (AUROC ¼ 0.852) in the highly myopic group, and average RNFL thickness (AUROC ¼ 0.920); the 6o'clock sector (AUROC ¼ 0.851); and the minimum GCIPL thickness (AUROC ¼ 0.908) in the nonhighly myopic group.…”

Changes in retinal nerve fiber layer and optic disc algorithms by optical coherence tomography in glaucomatous Arab subjects

“……”

Stratus-OCT imaging in early glaucomatous and in ocular hypertensive patients with and without frequency-doubling technology abnormalities

“…These results are in agreement with several studies that showed that both previous OCT versions, 12,[21][22][23][24][25] and the current Stratus-OCT 26-28 perform well in discriminating glaucomatous eyes with early SAP defects from control eyes. On the other hand, studies have shown that OCT and SAP do not correlate so well in glaucoma suspects defined as eyes with suspicious optic disc cupping and normal SAP.…”

Glaucoma Detection Ability of Ganglion Cell-Inner Plexiform Layer Thickness by Spectral-Domain Optical Coherence Tomography in High Myopia

“…15,16,[40][41][42] Moreover, in those investigations, inferior RNFL thickness often demonstrated the best ability for discriminating normal eyes from glaucoma, with sensitivities between 38% and 82% for specificities of 90% or higher. 15,[40][41][42][43][44][45][46][47] And in other previous studies, macular GCIPL thickness showed AUROC of 0.64 to 0.99, with sensitivities ranging from 60% to 95%, 15,16 which are results similar to those reported here for the present study. In our study, the best SD-OCT (Carl Zeiss Meditec) parameters with the largest AUROC were inferior RNFL thickness (AUROC ¼ 0.906); the 7-o'clock sector (AUROC ¼ 0.840); and the inferotemporal GCIPL (AUROC ¼ 0.852) in the highly myopic group, and average RNFL thickness (AUROC ¼ 0.920); the 6o'clock sector (AUROC ¼ 0.851); and the minimum GCIPL thickness (AUROC ¼ 0.908) in the nonhighly myopic group.…”

Changes in retinal nerve fiber layer and optic disc algorithms by optical coherence tomography in glaucomatous Arab subjects

“……”

Stratus-OCT imaging in early glaucomatous and in ocular hypertensive patients with and without frequency-doubling technology abnormalities

“…These results are in agreement with several studies that showed that both previous OCT versions, 12,[21][22][23][24][25] and the current Stratus-OCT 26-28 perform well in discriminating glaucomatous eyes with early SAP defects from control eyes. On the other hand, studies have shown that OCT and SAP do not correlate so well in glaucoma suspects defined as eyes with suspicious optic disc cupping and normal SAP.…”

Glaucoma Detection Ability of Ganglion Cell-Inner Plexiform Layer Thickness by Spectral-Domain Optical Coherence Tomography in High Myopia

“…15,16,[40][41][42] Moreover, in those investigations, inferior RNFL thickness often demonstrated the best ability for discriminating normal eyes from glaucoma, with sensitivities between 38% and 82% for specificities of 90% or higher. 15,[40][41][42][43][44][45][46][47] And in other previous studies, macular GCIPL thickness showed AUROC of 0.64 to 0.99, with sensitivities ranging from 60% to 95%, 15,16 which are results similar to those reported here for the present study. In our study, the best SD-OCT (Carl Zeiss Meditec) parameters with the largest AUROC were inferior RNFL thickness (AUROC ¼ 0.906); the 7-o'clock sector (AUROC ¼ 0.840); and the inferotemporal GCIPL (AUROC ¼ 0.852) in the highly myopic group, and average RNFL thickness (AUROC ¼ 0.920); the 6o'clock sector (AUROC ¼ 0.851); and the minimum GCIPL thickness (AUROC ¼ 0.908) in the nonhighly myopic group.…”