Influence of Bruch's Membrane Opening Area in Diagnosing Glaucoma With Neuroretinal Parameters From Optical Coherence Tomography.
Torres Lucas A, Sharpe Glen P, Hutchison Donna M, Zangalli Camila S, Burk Reinhard O, Reis Alexandre S C, Costa Vital P, Nicolela Marcelo T, Chauhan Balwantray C, Vianna Jayme R
AI Summary
This study found RNFLT glaucoma diagnostic sensitivity was higher in eyes with larger BMOA, but MRW sensitivity was BMOA-independent, suggesting BMOA may influence RNFLT interpretation.
Abstract
Purpose
To determine whether the glaucoma diagnostic accuracy of age- and Bruch membrane opening area (BMOA)-adjusted normative classifications of minimum rim width (MRW) and retinal nerve fiber layer thickness (RNFLT) is dependent on BMOA, in a European descent population.
Design
Retrospective, cross-sectional study.
Methods
We included 182 glaucoma patients and 166 healthy controls for the primary study, and 105 glaucoma patients in a second sample used for a replication study. Optical coherence tomography (Spectralis) measurements of BMOA, global MRW, and RNFLT and normative classifications from the device software were exported for analysis. Sensitivity and specificity were calculated for a conservative criterion (abnormal = "outside normal limits" classification) and a liberal criterion (abnormal = "outside normal limits" or "borderline" classifications). The dependence of sensitivity and specificity on BMOA was analyzed with comparison among subgroups divided by tertiles of BMOA, and with logistic regression.
Results
For the conservative criterion, MRW sensitivity was independent of BMOA (P ≥ .76), while RNFLT sensitivity increased in the large BMOA subgroup (P = .04, odds ratio: 1.2 per mm 2 [P = .02]). For the liberal criterion, MRW and RNFLT sensitivities were independent of BMOA (P ≥ .53). Specificities were independent of BMOA (P ≥ .07). For the replication sample, which included younger patients with larger BMOA and worse visual field damage than the primary sample, sensitivities were independent of BMOA for both criteria (P ≥ .10).
Conclusions
RNFLT sensitivity was higher in eyes with larger BMOA; however, age and visual field damage may influence that association. MRW diagnostic accuracy was not dependent on BMOA.
MeSH Terms
Shields Classification
Key Concepts4
In a retrospective, cross-sectional study of 182 glaucoma patients and 166 healthy controls, the sensitivity of minimum rim width (MRW) for diagnosing glaucoma using a conservative criterion (abnormal = "outside normal limits" classification) was independent of Bruch membrane opening area (BMOA) (P ≥ .76).
In a retrospective, cross-sectional study of 182 glaucoma patients and 166 healthy controls, the sensitivity of retinal nerve fiber layer thickness (RNFLT) for diagnosing glaucoma using a conservative criterion (abnormal = "outside normal limits" classification) increased in the large Bruch membrane opening area (BMOA) subgroup (P = .04, odds ratio: 1.2 per mm2 [P = .02]).
In a retrospective, cross-sectional study of 182 glaucoma patients and 166 healthy controls, the specificities of both minimum rim width (MRW) and retinal nerve fiber layer thickness (RNFLT) for diagnosing glaucoma were independent of Bruch membrane opening area (BMOA) (P ≥ .07) for both conservative and liberal criteria.
In a replication sample of 105 glaucoma patients, the sensitivities of minimum rim width (MRW) and retinal nerve fiber layer thickness (RNFLT) for diagnosing glaucoma were independent of Bruch membrane opening area (BMOA) for both conservative and liberal criteria (P ≥ .10).
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