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

Abstract

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.

Estimation of the Absolute Defects in the Visual Field using OCT in Glaucoma Patients who Cannot Perform a Reliable Test.

“…The mean RNFL thickness tipping point was 89µm. In Aydogan's study, it was 90µm [25]. The maximum average RNFL thickness that was measured in our study was below all of these levels.…”

Macula Vessel Density and Thickness in Early Primary Open-Angle Glaucoma

“…First, the definition of pre-perimetric glaucoma of Triolo et al differed from others. 11,24,25 They defined preperimetric glaucoma eyes as having average and quadrant RNFL thickness within 95% and 99% confidence limits. Such a definition may cause selection bias as only "healthier" preperimetric glaucoma eyes were included.…”

“…3 Pre-perimetric glaucoma was defined as eyes having optic discs appearance suspicious of glaucoma but without evidence of repeatable glaucomatous VF damage. 11,24,25 A suspicious appearing optic disc was defined as a disc with observable excavation, neuroretinal rim narrowing or notching, or a localized or diffuse RNFL defect suggestive of glaucoma with stereophotographs. 23 RNFL thickness measurement by OCT was not considered as a criterion of pre-perimetric glaucoma.…”

Optical Coherence Tomography Evaluation of Peripapillary and Macular Structure Changes in Pre-perimetric Glaucoma, Early Perimetric Glaucoma, and Ocular Hypertension: A Systematic Review and Meta-Analysis

“…After excluding this study, heterogeneity was largely reduced (I 2 = 34%, Supplementary Figure 12) and the funnel plot became symmetrical (Table 6 and Supplementary Figure 13, P-value of Egger's test increased from 0.195 to 0.745). In addition, the sensitivity analysis of average mGCC thickness in PPG eyes and EG eyes demonstrated that the study by Aydogan et al (39) was the major source of the heterogeneity (Table 8).…”

“…Several studies using OCT have reported that the attenuation of the peripapillary retinal nerve fiber layer (pRNFL), macular ganglion cell plus inner plexiform layer (GCIPL), and macular ganglion cell complex (mGCC) could be hallmark features of glaucoma ( 20 , 22 , 24 , 25 ). Although some investigations have revealed the continuum of glaucoma from mild to advanced stages, studies have shown inconsistencies regarding the diagnostic values of OCT indicators in differentiating PPG from EG ( 26 – 44 ) and in differentiating PPG from OHT ( 39 , 43 , 45 – 48 ).…”