J Korean Ophthalmol Soc.  2010 Sep;51(9):1250-1257. 10.3341/jkos.2010.51.9.1250.

Glaucoma Diagnostic Performance of Macular and Retinal Nerve Fiber Layer by Spectral-Domain Optical Coherence Tomography

• Lee Y
• Sung KR
• Hong JT
• Na JH

• KMID: 2122293
• DOI: http://doi.org/10.3341/jkos.2010.51.9.1250

Abstract

PURPOSE
To compare the performance of glaucoma diagnosis according to the macular and peripapillary retinal nerve fiber layer (RNFL) thicknesses, as determined by spectral domain optical coherence tomography (OCT).
METHODS
Ninety-six normal, 63 early glaucoma and 37 moderate to advanced glaucomatous eyes were imaged by Cirrus OCT. The areas under the receiver operating characteristics curves (AUCs) of macular and RNFL thicknesses were calculated for discrimination of normal and glaucomatous eyes. The sensitivity and specificity of normative classification of each parameter were assessed.
RESULTS
The glaucoma diagnostic capability determined by AUC was greater when based on the peripapillary RNFL than the macular thickness (0.914, 0.775, p<0.001). Both the early and the moderate-to-advanced group showed higher AUCs in peripapillary RNFL thickness (early glaucoma group; 0.870, 0.670, p<0.001, moderate to advanced glaucoma group; 0.990, 0.954, p=0.03). The inferior outer sector of macular thickness showed highest sensitivity among the parameters (58%).
CONCLUSIONS
Although Cirrus OCT applied to determine macular thickness did not outperform that applied to determine peripapillary RNFL thickness in glaucoma diagnosis, applying Cirrus OCT to determine both thicknesses in diagnosis may help in understanding a patient's status.

Keyword

Cirrus spectral domain Optical coherence tomography; Glaucoma; Macular thickness; Peripapillary retinal nerve fiber layer thickness

MeSH Terms

Area Under Curve
Discrimination (Psychology)
Eye
Glaucoma
Nerve Fibers
Retinaldehyde
ROC Curve
Sensitivity and Specificity
Tomography, Optical Coherence
Retinaldehyde

Figure

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  Figure 1 The correlation between average macular and peripapillary retinal nerve fiber layer thickness (µm) measured by Cirrus spectral domain optical coherence tomography.

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  Figure 2 The receiver operating characteristic curve of average macular and peripapillary retinal nerve fiber layer thickness for discrimination between normal (96 eyes) and glaucomatous eyes (100 eyes). Sensitivities and specificities were described as percentage (%).

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  Figure 3 The receiver operating characteristic curve of average macular and peripapillary retinal nerve fiber layer thickness for discrimination between normal (96 eyes) and early glaucomatous eyes (63 eyes). Sensitivities and specificities were described as percentage (%).

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  Figure 4 The receiver operating characteristic curve of average macular and peripapillary retinal nerve fiber layer thickness for discrimination between normal (96 eyes) and moderate to advanced glaucomatous eyes (37 eyes). Sensitivities and spcificities were described as percentage (%).

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