Identification of the Most Accurate Spectral-domain Optical Coherence Tomography Parameters in Eyes With Early High-Tension and Low-Tension Glaucoma

Gracitelli, Carolina P. B.; Moreno, Pilar A.; Leite, Mauro T.; Prata, Tiago S.

doi:10.1097/ijg.0000000000000406

Cited by 4 publications

(4 citation statements)

References 53 publications

(62 reference statements)

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“…Taking this into account, it is essential to perform the correlation between structural and functional changes. Anatomical evaluation can be performed through stereoscopic retinography [6] and automated quantitative exams such as optical coherence tomography (OCT) which were developed with the aim of contributing to the diagnosis of the disease [7][8][9]. Nevertheless, the high cost can represent a limitation to the access of the referred diagnostic tools.…”

Section: Introductionmentioning

confidence: 99%

Optic Nerve Head Hemoglobin Levels in Glaucoma: A Structural and Functional Correlation Study

Rocha

Dias

Lemos

et al. 2021

Journal of Ophthalmology

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Purpose. To investigate structural and functional correlations in glaucoma patients using optic nerve head hemoglobin (ONH Hb) measurements as determined by automated colorimetric analysis of conventional retinography. Methods. We prospectively enrolled healthy participants and glaucomatous patients with a wide range of disease stages. All participants underwent visual field (VF) testing (standard automated perimetry, SAP), color fundus imaging (mydriatic retinography), and peripapillary retinal nerve fiber layer (pRNFL) assessment through spectral-domain optical coherence tomography (SD-OCT). Software Laguna ONhE was used to estimate the amount of ONH Hb and to determine the glaucoma discriminant function (GDF) index. Scatter plots were constructed, and regression analysis was used to investigate the correlations between GDF, average pRNFL thickness, and VF mean deviation (VFMD) index values. A secondary analysis was performed to compare each parameter between three different glaucoma groups divided according to VFMD values (mild, >−6 dB; moderate, −6 to −12 dB; and advanced, <−12 dB). Results. One hundred ninety-six eyes from 123 participants (69 with glaucoma and 54 controls) were enrolled. Overall, all parameters evaluated differed significantly between glaucomatous and control eyes ( p ≤ 0.001 ). The comparison of each parameter according to groups of disease stages revealed significant differences between controls and each of the glaucomatous groups ( p < 0.001 ). More pronounced changes in GDF values were observed in early disease stages. We found significant nonlinear correlations between GDF and VFMD values (R2 = 0.295, p < 0.001 ) and between pRNFL thickness and VFMD (R2 = 0.598, p < 0.001 ). A linear correlation was found between GDF and pRNFL thickness values (R2 = 0.195, p < 0.001 ). Conclusion. Our results showed significant associations between ONH Hb values and both structural and functional damage in glaucoma obtained by SD-OCT and SAP, respectively. The nonlinear correlation we found and the GDF behavior along different disease stages suggest that ONH Hb levels’ reduction may precede visual function changes in early glaucoma stages.

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Section: Introductionmentioning

confidence: 99%

Optic Nerve Head Hemoglobin Levels in Glaucoma: A Structural and Functional Correlation Study

Rocha

Dias

Lemos

et al. 2021

Journal of Ophthalmology

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“…For a VF to be considered reliable, fixation losses and false-positive errors were ≤15% and false-negative errors were ≤30%. [16,17] The main study outcome measurements were macular GCC thickness values and the pattern of macular GCC thinning as assessed by SD-OCT (focal loss or diffuse loss). Secondary outcomes were (1) analysis of pRNFL thickness values in ONHD patients as assessed by SD-OCT and (2) comparison…”

Section: Methodsmentioning

confidence: 99%

“…Healthy participants needed to have intraocular pressure <21 mmHg (based on two different visits) and no signs of ONHD or glaucomatous optic neuropathy (defined as cup-to-disc ratio >0.6, asymmetry between eyes ≥0.2, presence of localized defects of the pRNFL, and/or neuroretinal rim in the absence of any other anomalies that could explain such findings). [16,17] Exclusion criteria were age <18 years, best-corrected visual acuity ≤20/40, previous ocular surgery (except for uneventful cataract surgery), media opacity, and systemic conditions that could affect the visual system, cognitive or physical inability to perform perimetry test, history of ocular trauma, or concomitant ocular diseases other than ONHD.…”

Section: Participantsmentioning

confidence: 99%

Patterns of macular inner retinal layers involvement in eyes with optic nerve head drusen

Modesto¹,

Neto²,

Moura³

et al. 2019

cleverjournal

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Purpose: The purpose of this study was to investigate the macular inner retinal layers involvement in eyes with optic nerve head drusen (ONHD) using spectral-domain optical coherence tomography (SD-OCT). Methods: An observational case series was carried out. Consecutive patients with ONHD and age-matched healthy individuals were enrolled from a single center. Key exclusion criteria were significant media opacity, best-corrected visual acuity ≤20/40, and the presence of any ocular comorbidity. After inclusion, all patients underwent SD-OCT imaging, visual field (VF) testing (standard automated perimetry), and optic disc digital imaging. For SD-OCT, macular ganglion cell complex (GCC) and peripapillary retinal nerve fiber layer (pRNFL) protocols were obtained. SD-OCT examinations were classified as normal or abnormal (and subsequently as focal or diffuse loss pattern) based on previously described color-coded criteria. Results: A total of 19 eyes with ONHD and 20 control eyes were included in the study. The VF mean deviation for ONHD eyes was −4.6 ± 3.9 dB. Regarding macular inner retinal layers (GCC protocol) analysis in ONHD eyes, nine eyes (47.4%) had significant macular GCC thinning, of which seven presented focal loss pattern and two diffuse loss pattern. Overall, both macular and pRNFL parameters were significantly thinner in eyes with ONHD when compared to healthy controls (P < 0.05). Analyzing the ability of the SD-OCTs normative database to detect abnormalities, 42.1% of the patients were presented abnormalities in both pRNFL and GCC parameters, while only one case presented an SD-OCT abnormality restricted to the macular GCC protocol. Conclusions: Investigating macular inner retinal layers involvement in eyes with ONHD, we found detectable macular damage by SD-OCT in almost half of the cases. In most of these cases, macular damage had a focal loss pattern and was accompanied by concomitant pRNFL thinning.

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“…In order to improve diagnostic performance, objective imaging modalities have been incorporated, such as optical coherence tomography (OCT). 10–13 The use of these instruments, as well as the combination of different tests, can improve the diagnostic ability of non-specialists. 7 However, their high cost may limit their use on a large scale.…”

Section: Introductionmentioning

confidence: 99%

Automated Optic Nerve Head Hemoglobin Measurements versus General Ophthalmologists Evaluation to Differentiate Glaucomatous from Large Physiological Cupping: A Diagnostic Performance Comparative Study

Rocha,

Franco,

Magacho

et al. 2024

OPTH

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Purpose The aim of this study is to compare the diagnostic performance in differentiating patients with glaucoma from those with presumed large physiological optic disc cupping (LPC), using optic nerve head hemoglobin levels (ONH Hb), as a screening method, versus the evaluation of general ophthalmologists. Patients and Methods Twenty general ophthalmologists evaluated PowerPoint images of 40 patients with glaucoma and 40 presenting LPC. Presentation of patient’s exams were distributed as follows: Group 1 (GI): color retinography (CR), Group 2 (GII): CR + visual field (VF), Group 3 (GIII): CR + optical coherence tomography (OCT), Group 4 (GIV): CR + VF + OCT. The Laguna ONhE software was used to estimate ONH Hb based on CR. Main outcomes were the comparison of sensitivity and accuracy between general ophthalmologists’ evaluation and the glaucoma discriminant function (GDF) index from Laguna ONhE and also the agreement between examiners (Kappa statistics). Results Laguna ONhE GDF index demonstrated higher sensitivity values (GI- 90%; GII-90%; GIII-100%; GIV-100%) comparing to all groups (GI-59%; GII-86.5%; GIII-86.5%; GIV-68.5%). In GI, in which it was observed the worst accuracy result (64.8%), we found 75% for GDF. In GII, the accuracy was 81.3% and we found 55% for GDF. The highest agreement was in GII (Kappa=0.63; 95% CI=0.53–0.72), and the lowest in GI (Kappa=0.30; 95% CI=0.20–0.39). Conclusion Laguna ONhE software, a low-cost and non-invasive method, showed good sensitivity and great utility as a screening method in differentiating patients with glaucoma from those with LPC, compared with evaluation of general ophthalmologists.

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Identification of the Most Accurate Spectral-domain Optical Coherence Tomography Parameters in Eyes With Early High-Tension and Low-Tension Glaucoma

Abstract: In eyes with early glaucoma, the pRNFL thickness scan seems to be a more accurate SDOCT protocol to identify those with LTG compared with the GCC thickness scan.

Cited by 4 publications

References 53 publications

Optic Nerve Head Hemoglobin Levels in Glaucoma: A Structural and Functional Correlation Study

Optic Nerve Head Hemoglobin Levels in Glaucoma: A Structural and Functional Correlation Study

Patterns of macular inner retinal layers involvement in eyes with optic nerve head drusen

Automated Optic Nerve Head Hemoglobin Measurements versus General Ophthalmologists Evaluation to Differentiate Glaucomatous from Large Physiological Cupping: A Diagnostic Performance Comparative Study

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