Evaluation of Retinal Nerve Fiber Layer Thickness Measurements for Glaucoma Detection

Bertuzzi, Francesca; Benatti, Eleonora; Esempio, Giulia; Rulli, Eliana; Miglior, Stefano

doi:10.1097/ijg.0b013e3182741afc

Cited by 12 publications

(13 citation statements)

References 17 publications

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“…Comparison of healthy subjects with OHT patients was not statistically significant as reported in earlier studies. [ 6 7 8 ] Comparisons for OR parameters were significant only when comparing healthy controls with PPG and EG patients. This finding agrees with other studies suggesting that OR parameters are affected less during the course of glaucoma.…”

Section: Discussionmentioning

confidence: 99%

“…In some studies, GCC parameters showed similar diagnostic ability with RNFL parameters. [ 8 13 14 15 16 17 18 19 ] Moreno et al . [ 20 ] reported that GCC parameters have slightly superior ability to discriminate between eyes with EG and controls.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have been carried out to evaluate the diagnostic ability of different OCT parameters for glaucoma. [ 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 ] We aimed to conduct a study with four study groups to investigate every aspect of OCT parameters in glaucoma diagnosis and elicit the more important parameters in clinical practice.…”

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confidence: 99%

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Evaluation of spectral domain optical coherence tomography parameters in ocular hypertension, preperimetric, and early glaucoma

Aydoğan

Akçay

Kardeş

et al. 2017

Indian J Ophthalmol

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Purpose:The objective of this study is to evaluate the diagnostic ability of retinal nerve fiber layer (RNFL), macular, optic nerve head (ONH) parameters in healthy subjects, ocular hypertension (OHT), preperimetric glaucoma (PPG), and early glaucoma (EG) patients, to reveal factors affecting the diagnostic ability of spectral domain-optical coherence tomography (SD-OCT) parameters and risk factors for glaucoma.Methods:Three hundred and twenty-six eyes (89 healthy, 77 OHT, 94 PPG, and 66 EG eyes) were analyzed. RNFL, macular, and ONH parameters were measured with SD-OCT. The area under the receiver operating characteristic curve (AUC) and sensitivity at 95% specificity was calculated. Logistic regression analysis was used to determine the glaucoma risk factors. Receiver operating characteristic regression analysis was used to evaluate the influence of covariates on the diagnostic ability of parameters.Results:In PPG patients, parameters that had the largest AUC value were average RNFL thickness (0.83) and rim volume (0.83). In EG patients, parameter that had the largest AUC value was average RNFL thickness (0.98). The logistic regression analysis showed average RNFL thickness was a risk factor for both PPG and EG. Diagnostic ability of average RNFL and average ganglion cell complex thickness increased as disease severity increased. Signal strength index did not affect diagnostic abilities. Diagnostic ability of average RNFL and rim area increased as disc area increased.Conclusion:When evaluating patients with glaucoma, patients at risk for glaucoma, and healthy controls RNFL parameters deserve more attention in clinical practice. Further studies are needed to fully understand the influence of covariates on the diagnostic ability of OCT parameters.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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Evaluation of spectral domain optical coherence tomography parameters in ocular hypertension, preperimetric, and early glaucoma

Aydoğan

Akçay

Kardeş

et al. 2017

Indian J Ophthalmol

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“…Because of our small number of glaucomatous eyes, diagnostic accuracies of the examinations were lower than in many studies where the proportion of glaucomatous eyes has been higher and classification has been predefined by VF and ONH findings (14,16,22,(28)(29)(30). In our study, as in others (32), the tests disagreed in classifying eyes as glaucomatous and healthy.…”

Section: Discussionmentioning

confidence: 71%

“…In all studies testing diagnostic accuracy, results depend on the reference. In many of those studies, nearly half the patients had glaucoma, and half have been healthy (14,16,22,(28)(29)(30). This is uncommon in real life.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Accuracy of Glaucoma Tests in Everyday Practice

Lindbohm

Vesti

Puska

et al. 2017

Ophthalmology @ Point of Care

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of CARE can be visualized with red-free photographs of the RNFL (3). However, diagnosing glaucoma in the early or moderate stage can be challenging. Appearance of the healthy ONH varies, and discrimination between healthy and glaucomatous ONH may be difficult in early glaucoma (4). Visual field testing is the only way to measure the functional damages glaucoma causes, but the success of VF testing depends on the patient's subjective performance, and is vulnerable to many possible artefacts (5). Sometimes VF defects appear only after structural damage is already detectable (6). Interpretation of RNFL red-free photographs is also difficult. Slit-like defects may be easily detectable, but diffuse defects of the RNFL may go undetected. Retinal nerve fiber layer red-free photography is also dependent on the clarity of the optical media and on sufficient pigmentation of the retinal pigment epithelium (3). In glaucoma diagnostics, new diagnostic methods offer benefits. Scanning laser polarimetry (SLP) and optical coherence tomography (OCT) allow quantitative measurements of the RNFL thickness around the ONH (7). The advantages of SLP and OCT measurements are that they are noninvasive, are quick to perform, and allow comparison of their measurements against normative databases. Thus, they have become

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Genetic and Environmental Factors Associated With the Ganglion Cell Complex in a Healthy Aging British Cohort

et al. 2017

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IMPORTANCE Measurement of ganglion cell complex (GCC) thickness may be more sensitive than current methods for glaucoma diagnosis and research. However, little is known about the factors influencing GCC thickness in the general population.OBJECTIVES To investigate the heritability of and factors associated with GCC thickness in a healthy aging population. DESIGN, SETTING, AND PARTICIPANTSA cross-sectional twin study was conducted from August 27, 2014, to March 31, 2016, among 1657 participants of white British ancestry from the TwinsUK study cohort without ocular pathologic conditions. Heritability analyses were conducted in 1432 twins (426 monozygous and 290 dizygous pairs). Association analyses were performed using univariable and multivariable stepwise linear regression models, taking family structure into account. Heritability analyses were conducted using maximum likelihood structural equation twin modeling. MAIN OUTCOMES AND MEASURESParameters measured included GCC thickness, autorefraction, intraocular pressure, blood pressure, body mass index, and cholesterol, creatinine, glucose, insulin, triglycerides, and urea levels. Estimated glomerular filtration rate was calculated using the Modification of Diet in Renal Disease formula. RESULTS Among the 1657 participants (mean [SD] age, 56.0 [15.3] years; 89.5% women and 10.5% men), the mean [SD] inner GCC thickness was 96.0 [7.6] μm (95% CI, 95.1-96.2). In multivariable modeling, the mean inner GCC thickness was associated with advancing age (β, -0.14; P < .001), increased body mass index (β, -0.15; P = .001), spherical equivalent (β, 0.70; P < .001), and higher estimated glomerular filtration rate (β, 0.03; P = .02). A 1-U increase in age or body mass index was associated with a 0.14-μm and 0.15-μm decrease in GCC thickness, respectively (P < .001), while a 1-U increase in spherical equivalent or estimated glomerular filtration rate was associated with a 0.70-μm (P < .001) and 0.03-μm (P = .02) increase in GCC thickness, respectively. Ganglion cell complex thickness was not associated with sex, intraocular pressure, or diabetes. Age-adjusted GCC thickness was highly heritable, with additive genetic effects explaining 81% (95% CI, 78%-84%) of phenotypic variance and individual environmental factors explaining the remaining 19% (95% CI, 16%-22%).CONCLUSIONS AND RELEVANCE Ganglion cell complex thickness appears to be highly heritable and further genetic analysis may help identify new biological pathways for glaucoma. The results suggest it may be important to account for age, body mass index, refractive error, and sex when using GCC thickness as a diagnostic tool. Replication of their results is required, as is further research to explain the association between renal function and GCC thickness.

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Evaluation of Retinal Nerve Fiber Layer Thickness Measurements for Glaucoma Detection

Abstract: GDx ECC and RTVue show a very good diagnostic ability to detect glaucoma. Most of the RNFL parameters had high AUCs and sensitivities. The diagnostic validity of GCC was comparable with that of the RNFL parameters, and they may be very useful in detecting RNFL damage.

Cited by 12 publications

References 17 publications

Evaluation of spectral domain optical coherence tomography parameters in ocular hypertension, preperimetric, and early glaucoma

Evaluation of spectral domain optical coherence tomography parameters in ocular hypertension, preperimetric, and early glaucoma

Diagnostic Accuracy of Glaucoma Tests in Everyday Practice

Genetic and Environmental Factors Associated With the Ganglion Cell Complex in a Healthy Aging British Cohort

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