Frequency-doubling technology and retinal measurements with spectral-domain optical coherence tomography in preperimetric glaucoma

Asymmetry Analysis of Macular Inner Retinal Layers for Glaucoma Diagnosis

“…Earlier studies showed that thicknesses of the RNFL, ganglion cell layer þ inner plexiform layer, and ganglion cell complex as measured on SD OCT better discriminate between normal and glaucomatous eyes than does thickness of the total retina and have discriminating ability comparable to that of cpRNFL thickness. [8][9][10][11][12][13][14][15][16][17][18][19] However, it has also been reported that glaucoma discriminating ability is less with less severe glaucoma. [8][9][10][11][12][13][14][15][16][17][18][19] In the current study, the areas under the receiver operating characteristic curve of macular retinal layer thicknesses, even of ganglion cell layer thickness, were smaller in eyes with earlier glaucoma, consistent with the results of earlier studies.…”

“…Previous studies reported large overlap of macular retinal layer thicknesses between normal and early glaucomatous eyes. [8][9][10][11][12][13][14][15][16][17][18][19] For example, Tan and associates measured macular ganglion cell complex thicknesses (mean 6 SD) of 76.6-119.0 (94. 8 Comparison was made for AROCs using the method of DeLong and associates.…”

“…[8][9][10][11][12][13][14][15][16][17][18][19] Studies using this technology found that thicknesses of single or combined inner retinal layers, such as the RNFL, ganglion cell layer þ inner plexiform layer (termed GCIPL [Carl Zeiss Meditec, Dublin, California, USA] or GCLþ [Topcon, Tokyo, Japan]), and RNFL þ ganglion cell layer þ inner plexiform layer (termed ganglion cell complex [GCC]), in the macula were more accurate than total macular thickness and were comparable to circumpapillary (cp) RNFL thickness in discriminating between glaucomatous and nonglaucomatous eyes. [8][9][10][11][12][13][14][15][16][17][18][19] However, these thickness parameters do not satisfactorily discriminate between normal and preperimetric glaucoma eyes: areas under the receiver operating characteristic curve for average, superior, and inferior macular retinal layer thicknesses were reported as 0.78, 8 18 and 0.76-0.79, 19 and at > _95% specificity, sensitivities were reported as 43. .5% 17 and 31.3-43.8.…”

“…19 One possible reason for this limitation of retinal thickness parameters in detecting glaucoma before VF defects appear is that there is a wide overlap in the thickness distribution of these structure parameters between normal and earlydiseased eyes. [8][9][10][11][12][13][14][15][16][17][18][19] It is difficult to statistically distinguish 2 groups with a wide overlap. For a change in a structure to be a reliable indicator of early glaucoma, the range of abnormal values for the structure must have minimal overlap with the range for this structure in normal eyes.…”

Comparison of macular ganglion cell complex thickness to total retinal thickness ratio between Hungarian and Japanese eyes

“…Use of novel structural tests may improve clinical diagnosis, since for early glaucomatous visual field damage to be detected approximately 30 % of the retinal ganglion cells need to be lost [1]. Retinal nerve fiber layer (RNFL) thickness parameters of Fourier-domain (FD) optical coherence tomography (OCT) are believed to have diagnostic accuracy [2][3][4][5][6][7][8]; however, inner macular thickness parameters, which comprise tissue layers directly influenced by glaucomatous ganglion cell loss, show comparable or even higher diagnostic accuracy, particularly in detection of very early glaucoma, and in myopic eyes [9][10][11][12][13][14][15]. The RTVue-100 OCT (Optovue Inc., Fremont, CA, USA) is a new FD OCT systems.…”