Optic Disk and Nerve Fiber Layer Imaging to Detect Glaucoma

Abstract

Purpose-To compare optic disc and retinal nerve fiber layer (RNFL) imaging methods to discriminate eyes with early glaucoma from normal eyes.Design-Retrospective, cross-sectional study. Methods-Setting:Tertiary care academic glaucoma center. Ninety-two eyes of 92 subjects (46 with early perimetric open-angle glaucoma and 46 controls) were studied. Diagnostic performance of optical coherence tomography (StratusOCT), scanning laser polarimetry (GDx-VCC), confocal laser ophthalmoscopy (Heidelberg Retinal Tomograph III), and qualitative assessment of stereoscopic optic disc photographs were compared. Outcome measures were areas under receiver operator characteristic curves (AUC) and sensitivities at fixed specificities. Classification and Regression Trees (CART) analysis was used to evaluate combinations of quantitative parameters.Results-The average (±SD) visual field mean deviation for glaucomatous eyes was −4.0±2.5 dB. Parameters with largest AUCs (±SE) were: average RNFL thickness for StratusOCT (0.96±0.02), nerve fiber indicator for GDx-VCC (0.92±0.03), FSM discriminant function for HRT III (0.91±0.03), and 0.97±0.02 for disc photograph evaluation. At 95% specificity, sensitivity of disc photograph evaluation (90%) was greater than GDx-VCC (p=0.05) and HRT III (p=0.002), but not significantly different than that of StratusOCT (p>0.05). Combination of StratusOCT average RNFL thickness and HRT III cup/disc area with CART produced a sensitivity of 91% and specificity of 96% Conclusions-StratusOCT, GDx-VCC, and HRT III performed as well as, but not better than, qualitative evaluation of optic disc stereophotographs for detection of early perimetric glaucoma. The combination of StratusOCT average RNFL thickness and HRT III cup/disc area ratio provided a high diagnostic precision.

Evaluation of optic nerve head and retinal nerve fiber layer in early and advance glaucoma using frequency-domain optical coherence tomography

“…In ONH evaluation, the largest AUC was for the vertical C-D ratio, in differentiating normal subjects from moderate (0.951) and the early (0.911) glaucoma groups. Badalà et al [15] compared the ability of four currently used optic disk and RNFL imaging methods to discriminate eyes with early glaucomatous visual field loss from healthy eyes. Parameters with largest AUCs were: average RNFL thickness for StratusOCT (0.96), nerve fiber indicator for GDx VCC (0.92), Frederick S. Mikelberg (FSM) discriminant function for HRT III (0.91), and 0.97 for disk photograph evaluation.…”

Effect of Optic Disc Size and Disease Severity on the Diagnostic Capability of Glaucoma Imaging Technologies in an Indian Population

“…This was based on the results of earlier studies reporting the sensitivities and specificities of imaging techniques to be around 90% 21,22 and the mismatch between the techniques to be between 11% to 19% on the diagnostic categorization. 23 The sample size was estimated to be 70 participants in each group.…”

Glokom Hastalarında HRT III Cihazında MRA ve GPS Algoritmalarının Tanısal Değerlerinin Karşılaştırılması

“…Badala ve ark. 21 ve De Leon-Ortega ve ark. 22 ise çalışmalarında en yüksek eğri altında kalan alana sahip parametreleri sırasıyla çukurluk/disk alanı (0,91) ve lineer çukurluk/disk alanını (0,85) olarak bildirmişlerdir.…”