J GlaucomaApril 201713 citations

Glaucoma Diagnostic Capability of Circumpapillary Retinal Nerve Fiber Layer Thickness in Circle Scans With Different Diameters.

Ghassibi Mark P, Chien Jason L, Patthanathamrongkasem Thipnapa, Abumasmah Ramiz K, Rosman Michael S, Skaat Alon, Tello Celso, Liebmann Jeffrey M, Ritch Robert, Park Sung Chul

View on PubMed DOI: 10.1097/IJG.0000000000000610

AI Summary

This study found the 4.1mm OCT scan diameter's inferotemporal RNFLT offered superior glaucoma diagnostic capability, suggesting optimizing scan parameters can improve early detection and reduce artifacts.

Abstract

Purpose

To compare varying circumpapillary optical coherence tomographic (OCT) scan diameters for glaucoma diagnosis.

Materials and methods

Prospective, cross-sectional, observational study. Circumpapillary retinal nerve fiber layer thickness (RNFLT) was measured using spectral-domain OCT in 1 randomly selected eye. Scans with diameters of 3.5, 4.1, and 4.7 mm were obtained, each with 7 parameters: mean global (G) RNFLT and mean RNFLT for the temporal-inferior (TI), nasal-inferior (NI), temporal-superior (TS), nasal-superior (NS), nasal (N), and temporal (T) sectors. Areas under the receiver operating characteristic curve (AUCs) were calculated.

Results

Mean age was 55±18 years in 68 healthy eyes and 59±15 years in 95 glaucomatous eyes (P=0.12). Visual field mean deviation was -7.55±6.61 dB in glaucomatous eyes. In all 3 circle scans, mean TI RNFLT had the greatest AUC (0.974 to 0.983), followed by mean G RNFLT (0.949 to 0.956). The AUC of mean TI RNFLT in the 4.1-mm scan (0.983) was greater than the AUCs of mean TI RNFLTs in the 4.7- (0.978; P=0.128) and 3.5-mm (0.974; P=0.049) scans. The AUC of mean TI RNFLT in the 4.1-mm scan (0.983) was greater than the AUCs of mean G RNFLTs in the 3.5- (0.954; P=0.011), 4.1- (0.956; P=0.016), and 4.7-mm (0.949; P=0.011) scans. In 2 eyes with large parapapillary atrophy, RNFL segmentation error was noted only in the 3.5-mm scan in the area of parapapillary atrophy.

Conclusions

Further investigations to find the spectral-domain OCT circle scan diameter with the best diagnostic capability and the least artifacts are warranted, especially focusing on larger-than-conventional circle scans.

MeSH Terms

AdultAgedArea Under CurveCross-Sectional StudiesFemaleGlaucomaHumansIntraocular PressureMaleMiddle AgedNerve FibersProspective StudiesROC CurveRetinaTomography, Optical CoherenceVisual Fields

Shields Classification

Ch. 4Optic Nerve, Retina, and Choroid

Ch. 5Assessment of Visual Fields

Ch. 27Management of the Glaucoma Patient

Key Concepts4

In a prospective, cross-sectional, observational study of 68 healthy eyes and 95 glaucomatous eyes, the mean temporal-inferior (TI) retinal nerve fiber layer thickness (RNFLT) measured with spectral-domain OCT in the 4.1-mm scan had the greatest area under the receiver operating characteristic curve (AUC) (0.983) for glaucoma diagnosis.

DiagnosisCross-sectionalProspective, cross-sectional, observational studyn=68 healthy eyes and 95 glaucomatous eyesCh5Ch12

In a prospective, cross-sectional, observational study of 68 healthy eyes and 95 glaucomatous eyes, the AUC of mean TI RNFLT in the 4.1-mm scan (0.983) was greater than the AUCs of mean TI RNFLTs in the 4.7-mm (0.978; P=0.128) and 3.5-mm (0.974; P=0.049) scans for glaucoma diagnosis.

Comparative EffectivenessCross-sectionalProspective, cross-sectional, observational studyn=68 healthy eyes and 95 glaucomatous eyesCh5Ch12

In a prospective, cross-sectional, observational study of 68 healthy eyes and 95 glaucomatous eyes, the AUC of mean temporal-inferior (TI) retinal nerve fiber layer thickness (RNFLT) in the 4.1-mm scan (0.983) was greater than the AUCs of mean global (G) RNFLTs in the 3.5-mm (0.954; P=0.011), 4.1-mm (0.956; P=0.016), and 4.7-mm (0.949; P=0.011) scans for glaucoma diagnosis.