Elsevier

Ophthalmology

Volume 117, Issue 9, September 2010, Pages 1692-1699.e1
Ophthalmology

Original article
Comparison of Different Spectral Domain Optical Coherence Tomography Scanning Areas for Glaucoma Diagnosis

https://doi.org/10.1016/j.ophtha.2010.01.031Get rights and content

Purpose

To evaluate retinal nerve fiber layer (RNFL), optic nerve head (ONH), and macular thickness measurements for glaucoma detection using the RTVue spectral domain optical coherence tomograph.

Design

Diagnostic, case-control study.

Participants

One hundred forty eyes of 106 glaucoma patients and 74 eyes of 40 healthy subjects from the Diagnostic Innovations in Glaucoma Study (DIGS).

Methods

All patients underwent ocular imaging with the commercially available RTVue. Optic nerve head, RNFL thickness, and macular thickness scans were obtained during the same visit. Receiver operating characteristic (ROC) curves and sensitivities at fixed specificities (80% and 95%) were calculated for each parameter.

Main Outcome Measures

Areas under the ROC curves (AUC) and sensitivities at fixed specificities of 80% and 95%.

Results

The AUC for the RNFL parameter with best performance, inferior quadrant thickness, was significantly higher than that of the best-performing ONH parameter, inferior rim area (0.884 vs 0.812, respectively; P = 0.04). There was no difference between ROC curve areas of the best RNFL thickness parameters and the best inner macular thickness measurement, ganglion cell complex root mean square (ROC curve area = 0.870).

Conclusions

The RTVue RNFL and inner retinal macular thickness measurements had good ability to detect eyes with glaucomatous visual field loss and performed significantly better than ONH parameters.

Financial Disclosure(s)

Proprietary or commercial disclosure may be found after the references.

Section snippets

Methods

This diagnostic, case-control study included participants in a prospective, longitudinal study designed to evaluate optic nerve structure and visual function in glaucoma (Diagnostic Innovations in Glaucoma Study) conducted at the Hamilton Glaucoma Center, University of California, San Diego. Participants in the Diagnostic Innovations in Glaucoma Study include normal subjects, patients with glaucoma, and glaucoma suspects, who are longitudinally evaluated clinically and with several functional

Results

Of the 46 normal subjects and 107 glaucoma patients who had imaging with RTVue, 2 normal subjects and 1 glaucoma patient were excluded because of the baseline disc drawing not being consistent with the scan in both eyes, leaving 74 eyes of 44 normal subjects and 140 eyes of 106 glaucoma patients for the analysis.

Age, ethnicity, and visual field parameters of the 2 groups of participants are shown in Table 1. Patients in the glaucoma group were significantly older than the subjects in the normal

Discussion

To our knowledge, this is the first study to compare the diagnostic accuracies of the different RTVue scanning protocols for glaucoma. We found that RNFL thickness and GCC parameters had good performance to discriminate healthy eyes from those with glaucomatous visual field loss and performed significantly better than ONH parameters.

The RNFL thickness parameter with best diagnostic performance was the inferior quadrant thickness, with an AUC of 0.884 and a sensitivity of 71.4% for a specificity

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  • Cited by (0)

    Manuscript no. 2009-1274.

    Financial Disclosure(s): Linda M. Zangwill – Grant/Financial Support - Heidelberg Engineering, Carl Zeiss, Optovue

    Robert N. Weinreb – Consultant, Grant/Financial Support - Optovue, Topcon, Carl Zeiss; Grant/Financial Support - Heidelberg Engineering

    Pamela A. Sample – Grant/Financial Support - Carl Zeiss, Heidelberg Engineering, Welch Allyn

    Felipe A. Medeiros – Consultant, Grant/Financial Support - Carl Zeiss; Lecture Fees - Heidelberg Engineering

    Supported in part by NEI EY08208 (PAS), NEI EY11008 (LMZ), Participant retention incentive grants in the form of glaucoma medication at no cost (Alcon Laboratories Inc., Allergan, Pfizer Inc., SANTEN Inc.).

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