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Wu J, Du Y, Lin C, Zhu Y, Chen W, Pan Q, Zhuo Y, Wang N. Retinal nerve fibre layer thickness measured with SD-OCT in a population-based study: the Handan Eye Study. Br J Ophthalmol 2022:bjophthalmol-2021-320618. [PMID: 35383049 PMCID: PMC10359552 DOI: 10.1136/bjophthalmol-2021-320618] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 03/13/2022] [Indexed: 12/17/2022]
Abstract
PURPOSE To examine the normative profile of retinal nerve fibre layer (RNFL) thickness and ocular parameters based on spectral-domain optical coherence tomography (SD-OCT) and its associations with related parameters among the Chinese population. METHODS This population-based cohort Handan Eye Study (HES) recruited participants aged≥30 years. All subjects underwent a standardised ophthalmic examination. Peripapillary RNFL thickness was obtained using SD-OCT. Mixed linear models were adopted to evaluate the correlation of RNFL thickness with ocular parameters as well as systemic factors. R V.3.6.1 software was used for statistical analysis. RESULTS 3509 subjects (7024 eyes) with the average age of 55.54±10.37 were collected in this analysis. Overall mean RNFL thickness measured was 113.46±10.90 µm, and the thickest quadrant of parapapillary RNFL was the inferior quadrant, followed by the superior quadrant, the nasal quadrant and the temporal quadrant. In the multivariate linear regression model, thinner RNFL thickness was remarkable association with male (p<0.001), older age (p<0.001), increased body mass index (>30, p=0.018), absence of diabetes (p=0.009), history of cataract surgery (p=0.001), higher intraocular pressure (p=0.007), lower spherical equivalent (p<0.001) and increased axial length (p=0.048). CONCLUSIONS In non-glaucoma individuals, this difference of RNFL thickness in Chinese population should be noted in making disease diagnoses. Meanwhile, multiple ocular and systemic factors are closely related to the thickness of RNFL. Our findings further emphasise the need to demonstrate ethnic differences in RNFL thickness and the specificity of associated ocular and systemic factors, as well as to develop better normative databases worldwide. TRIAL REGISTRATION NUMBER HES was registered in Chinese Clinical Trial Registry website, and the registry number was ChiCTR-EOC-17013214.
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Affiliation(s)
- Jian Wu
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China.,Department of Ophthalmology, Stanford University School of Medicine, Palo Alto, California, USA
| | - Yifan Du
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China
| | - Caixia Lin
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China
| | - Yingting Zhu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Wei Chen
- Department of Ophthalmology, Stanford University School of Medicine, Palo Alto, California, USA
| | - Qing Pan
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yehong Zhuo
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Ningli Wang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China
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Lee SH, Joiner DB, Tsamis E, Rajshekhar R, Kim E, De Moraes CG, Ritch R, Hood DC. OCT Circle Scans Can Be Used to Study Many Eyes with Advanced Glaucoma. Ophthalmol Glaucoma 2019; 2:130-135. [PMID: 31850400 DOI: 10.1016/j.ogla.2019.02.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Purpose To examine the utility of optical coherence tomography (OCT) for studying eyes with advanced glaucoma [i.e., eyes with a 24-2 visual field (VF) mean deviation (MD) worse than -15 dB], we tested the hypothesis that if these eyes had a 10-2 total deviation (TD) map with points better than -8 dB, then the topographically corresponding regions on the circumpapillary retinal nerve fiber layer (cpRNFL) should show a preserved region. Design Evaluation of technology study. Participants 39 eyes from 33 patients (mean: 68.8 ± 9.2 years) with a diagnosis of glaucoma had a 24-2 VF with a MD ≤ -15 dB (mean: -18.94 ± 2.95 dB). All eyes additionally had a 10-2 VF and an averaged OCT circle scan. Methods Each scan was inspected, and preserved cpRNFL regions of the disc associated with the macula (central ±8° were delin eated. Main Outcome Measures The number of eyes with preserved cpRNFL regions and their association with preserved VF locations (i.e. better than -8 dB) shown in the 10-2 VF TD map. Results 38 of the 39 eyes had one or more points on the 10-2 VF with TD values that were better than -8 dB (mean: 25.7 ± 12.6 points). For all 39 eyes, there was a preserved portion of the cpRNFL on the circle scan within the disc region associated with the macula. However, for 3 of these eyes, this region was hypodense and could be a challenge for the clinician to identify. Conclusion OCT scans can be used to assess and potentially follow the preserved regions of cpRNFL associated with the macula in eyes with advanced glaucoma if there is a preserved region on the 10-2 VF better than -8 dB.
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Affiliation(s)
- Seung H Lee
- Department of Psychology, Columbia University, New York, NY
| | - Devon B Joiner
- Department of Psychology, Columbia University, New York, NY
| | | | | | - Eleanor Kim
- Department of Psychology, Columbia University, New York, NY
| | - C Gustavo De Moraes
- Bernard and Shirlee Brown Glaucoma Research Laboratory, Edward S. Harkness Eye Institute, Department of Ophthalmology, Columbia University Medical Center, New York, New York
| | - Robert Ritch
- Einhorn Clinical Research Center, New York Eye and Ear Infirmary of Mount Sinai, New York, NY
| | - Donald C Hood
- Department of Psychology, Columbia University, New York, NY.,Bernard and Shirlee Brown Glaucoma Research Laboratory, Edward S. Harkness Eye Institute, Department of Ophthalmology, Columbia University Medical Center, New York, New York
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Optical Coherence Tomography and Glaucoma Progression: A Comparison of a Region of Interest Approach to Average Retinal Nerve Fiber Layer Thickness. J Glaucoma 2017; 26:473-477. [PMID: 28263263 DOI: 10.1097/ijg.0000000000000654] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To determine whether the change in the retinal nerve fiber layer (RNFL) thickness in a region of interest (ROI) is a better measure of glaucoma progression than the change in average circumpapillary (cp) RNFL thickness. METHODS Disc cube scans were obtained with frequency domain optical coherence tomography from 60 eyes of 60 patients (age, 61.7±12.7 y) with early or suspected glaucoma and controlled intraocular pressure. The average time between 2 test dates was 3.2±1.8 years. En-face images of the scans from the 2 tests were aligned based on the blood vessels, and cp images were derived for an annulus 100 μm wide and 3.4 mm in diameter, centered on the disc. An ROI was defined as the portion of the circumpapillary retinal nerve fiber layer (cpRNFL) plot within the temporal disc that extended below the 1% confidence interval for ≥5 degrees. Trend analysis using multilevel mixed-effects models was used to compare the rates of change between ROI width and average cpRNFL thickness. RESULTS In total, 26 of the 60 eyes had a total of 33 ROIs. The ROI width significantly increased between the 2 test dates (median, 4.9 degrees; Q1=1.03 degrees, Q3=10.5 degrees). In comparison, the average cpRNFL thickness did not decrease significantly over the same period (median, -0.7 μm; Q1=-2.7 μm, Q3=2.7 μm). Mixed-effects linear models confirmed significant ROI progression (P=0.015), but not average cpRNFL (P=0.878). CONCLUSIONS In this population, RNFL thinning in a ROI is a better measure of progression than is average cpRNFL thickness change.
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Cubuk M, Sahinoglu-Keskek N, Keskek SO. Retinal nerve fiber layer thickness in a healthy Turkish population measured by optical coherence tomography. Ann Saudi Med 2016; 36:409-413. [PMID: 27920413 PMCID: PMC6074200 DOI: 10.5144/0256-4947.2016.409] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Normative optical coherence tomography (OCT) data is required for different subsets of the population as ethnic differences in retinal nerve fiber layer (RNFL) thickness have been reported. An OCT database for the normal Turkish population is not commercially available. OBJECTIVES Quantify peripapillary RNFL thickness in a Turkish population. DESIGN Cross-sectional, descriptive study. SETTING Numune Training and Research Hospital, Adana, Turkey. SUBJECTS AND METHODS RNFL measurements performed by Spectral OCT with a circular scan with 3.4 mm circle were centered around the optic disc of the right eye of each subject. Correlation of the effects of age and gender on RNFL thickness was analyzed. MAIN OUTCOME MEASURE(S) Correlation and measurements of RNFL. Retinal nerve fiber layer thick- ness measurements were obtained for the entire circumference of the optic nerve head. RESULTS In 307 healthy subjects consisting of 135 (44%) males and 172 (56%) females, with a mean (SD) age of 35.1 (9.6) years (range, 20-50 years), RNFL was superior: 132.2 (16.63) micro m, inferior: 139.1 (14.53) micro m, nasal: 96.2 (14.23) micro m, temporal: 79.8 (10.7) micro m. The mean (SD) RNFL thickness for the group was 111.5 (9.3) micro m. There was no significant difference between the average RNFL thicknesses of age groups nor between males and females (P=.1, P=.42), and no significant correlation with respect to age (P=.430, r=-.04). There was a statistically significant difference between the inferior quadrants of the two genders (P=.04). CONCLUSIONS RNFL thickness did not vary significantly with gender. A weak negative but statistically nonsignificant correlation between average RNFL thickness and age was found. LIMITATIONS The participants were young adults or at early middle age so age effects on RNFL thickness may not be explained. The data does not reflect the entire Turkish population, which is not homogeneous.
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Affiliation(s)
| | | | - Sakir Ozgur Keskek
- Sakir Ozgur Keskek, Department of Internal Medicine,, Adana Numune Egitim ve Arastirma Hastanesi,, Adana, Turkey, T: +903223550101, F: +903223550105, , ORCID: http://orcid.org/0000-0001-5888-3123
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Hashemi H, Khabazkhoob M, Nabovati P, Yekta A, Emamian MH, Fotouhi A. Retinal nerve fibre layer thickness in a general population in Iran. Clin Exp Ophthalmol 2016; 45:261-269. [PMID: 27727492 DOI: 10.1111/ceo.12849] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Revised: 09/23/2016] [Accepted: 10/04/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND To determine retinal nerve fibre layer (RNFL) thickness distribution and its related factors in a general population of 45 to 69 year olds in Iran. DESIGN Population-based cross-sectional study. PARTICIPANTS Of the 5190 participants of phase one of Shahroud Eye Cohort Study, 4737 participated in Phase two (participation rate = 91.3%). METHODS All study participants underwent visual acuity measurement, refraction tests, slit lamp examination and ophthalmoscopic fundus exam. Tests also included imaging with Cirrus HD-OCT 4000 and its RNFL thickness data were used in this study. MAIN OUTCOME MEASURES The overall RNFL thickness and the average RNFL thickness in different quadrants. RESULTS Mean RNFL thickness in the superior, inferior, nasal and temporal quadrants were 92.47 µm [95% confidence interval (CI): 92.14-92.80], 111.22 µm (95% CI: 110.7-111.73), 118.93 µm (95% CI: 118.31-119.55), 74.83 µm (95% CI: 74.07-75.59) and 65.48 µm (95% CI: 65.06-65.90). Multiple linear regression models indicated that RNFL thickness in all quadrants decreased with ageing, was lower in females (coefficient:-0.87 and P = 0.015), decreased by 1.42 µm (P < 0.001) for each millimetre increase in axial length and decreased by 0.41 µm (P = 0.041) for each diopter decrease in spherical equivalent refraction of myopia. CONCLUSION RNFL thickness in the 45 to 69-year-old Iranian population is lower compared to other studies. This difference should be noted in making disease diagnoses, particularly glaucoma. Also, there is a significant relationship between ageing and RNFL thinning in all quadrants. Longer axial length, myopia and male gender are associated with reduced RNFL thickness.
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Affiliation(s)
- Hassan Hashemi
- Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran
| | - Mehdi Khabazkhoob
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran
| | - Payam Nabovati
- Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran
| | - Abbasali Yekta
- Department of Optometry, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Hassan Emamian
- Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Akbar Fotouhi
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Wang H, Tao Y, Sun XL, Zhuang K. Comparison of Heidelberg retina tomography, optical coherence tomography and Humphrey visual field in early glaucoma diagnosis. J Int Med Res 2013; 41:1594-605. [PMID: 24003055 DOI: 10.1177/0300060513489474] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To determine the value of optic disc parameters and perimetric defects in the early diagnosis of patients with primary open-angle glaucoma (POAG). METHODS Optic disc parameters and perimetry were compared among patients in the early stage of POAG, patients with suspected POAG and healthy control subjects, using Heidelberg retina tomography (HRT-II), optical coherence tomography (OCT) and a Humphrey 750i automatic field analyser, in order to determine whether these parameters could be used for early POAG diagnosis. RESULTS A total of 55 participants were enrolled in the study. Significant differences in the optic disc parameter and perimetry values were observed between the three groups. HRT-II parameters showed good correlation with OCT parameters. The majority of the HRT-II and OCT parameters showed a good correlation with perimetry values. CONCLUSIONS HRT-II and OCT optic disc parameters both reflect morphological changes of the optic disc. These current findings suggest that they can both detect glaucomatous optic neuropathy earlier than a white-on-white perimetry examination. In addition, OCT can detect optic disc parameter changes that cannot be detected by HRT-II.
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Affiliation(s)
- Hong Wang
- Department of Ophthalmology, Qilu Hospital, Shandong University, Jinan, Shandong Province, China
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Kim SH, Jeoung JW, Park KH, Kim TW, Kim DM. Correlation Between Retinal Nerve Fiber Layer Thickness and Visual Field Sensitivity: Diffuse Atrophy Imaging Study. Ophthalmic Surg Lasers Imaging Retina 2012; 43:S75-82. [DOI: 10.3928/15428877-20121001-01] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2011] [Accepted: 08/09/2012] [Indexed: 11/20/2022]
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Lee J, Song IS, Kim YJ, Cha YJ, Uhm KB. Comparison of Retinal Nerve Fiber Layer Thickness Measured by Spectral-Domain and Time-Domain Optical Coherence Tomography. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2012. [DOI: 10.3341/jkos.2012.53.1.103] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Juhyang Lee
- Department of Ophthalmology, Hanyang University College of Medicine, Seoul, Korea
| | - In Seok Song
- Department of Ophthalmology, Hanyang University College of Medicine, Seoul, Korea
| | - Yu-Jeong Kim
- Department of Ophthalmology, Hanyang University College of Medicine, Seoul, Korea
| | - Yong Jae Cha
- Department of Ophthalmology, Hanyang University College of Medicine, Seoul, Korea
| | - Ki Bang Uhm
- Department of Ophthalmology, Hanyang University College of Medicine, Seoul, Korea
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Hwang JH, Uhm KB. Visual Field Cluster Map Corresponding to Retinal Nerve Fiber Layer Sectors in Glaucoma. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2011. [DOI: 10.3341/jkos.2011.52.5.557] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Jeong Hee Hwang
- Department of Ophthalmology, Hanyang University College of Medicine, Seoul, Korea
| | - Ki Bang Uhm
- Department of Ophthalmology, Hanyang University College of Medicine, Seoul, Korea
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Leung CKS, Cheung CYL, Weinreb RN, Liu S, Ye C, Lai G, Liu N, Pang CP, Tse KK, Lam DSC. Evaluation of retinal nerve fiber layer progression in glaucoma: a comparison between the fast and the regular retinal nerve fiber layer scans. Ophthalmology 2010; 118:763-7. [PMID: 21093920 DOI: 10.1016/j.ophtha.2010.08.014] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2010] [Revised: 08/06/2010] [Accepted: 08/06/2010] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To compare the performance of the fast (256 A-scans in each scan circle) and the regular (512 A-scans in each scan circle) retinal nerve fiber layer (RNFL) scan protocols for detection of glaucoma progression using the Stratus optical coherence tomography (OCT) device (Carl Zeiss Meditec, Dublin, CA). DESIGN Retrospective, longitudinal study. PARTICIPANTS One hundred twenty-nine eyes from 72 glaucoma patients. METHODS All patients had been followed up for 2.9 to 6.1 years with a median follow-up of 4 months. All eyes had at least 4 serial RNFL measurements obtained with both the fast and the regular RNFL scans. Visual field (VF) assessment was performed on the same day as RNFL imaging. Retinal nerve fiber layer thickness and VF progression were evaluated with linear regression analysis against age. The mean rate of average RNFL thickness reduction was estimated with linear mixed modeling. MAIN OUTCOME MEASURES The agreement of progression detection and the rate of change of RNFL thicknesses. RESULTS A total of 1373 fast and 1373 regular RNFL scans and 1236 VF tests were analyzed. With reference to the average RNFL thickness, the fast RNFL scan detected more eyes with progression (21 eyes from 19 patients vs. 15 eyes from 13 patients) than the regular scan at a comparable level of specificity (96.9% vs. 96.1%). More eyes were found to have increasing RNFL thickness with age at individual clock hours (except for 3, 5, 6, and 11 o'clock) when the measurements were obtained with the regular scan. The agreement between the fast and the regular scan for detection of RNFL progression was fair to moderate, with κ values ranging between 0.14 and 0.49. The rate of average RNFL thickness progression was -1.01 μm per year for the fast RNFL scan and -0.77 μm per year for the regular scan. CONCLUSIONS The choice of scan protocols in the Stratus OCT has a significant impact in the evaluation of RNFL progression. The fast RNFL scan seems to be preferable to follow RNFL damage in glaucoma.
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Affiliation(s)
- Christopher Kai-Shun Leung
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, People's Republic of China.
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Retinal Nerve Fiber Layer Thickness Measurement by Fourier-domain Optical Coherence Tomography: A Comparison Between Cirrus-HD OCT and RTVue in Healthy Eyes. J Glaucoma 2010; 19:369-72. [DOI: 10.1097/ijg.0b013e3181bdb55d] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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The correlation between visual field defects and focal nerve fiber layer thickness measured with optical coherence tomography in the evaluation of glaucoma. J Glaucoma 2009; 18:53-61. [PMID: 19142136 DOI: 10.1097/ijg.0b013e318179f751] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
PURPOSE To study the correlation between known visual field defects and retinal nerve fiber layer (RNFL) thickness detected by optical coherence tomography (OCT) in glaucomatous eyes. MATERIALS AND METHODS Visual field parameters and OCT RNFL measurements of 28 eyes of 28 glaucoma patients with various stages of glaucoma were compared with 38 eyes of 38 normal age-matched controls. A perimetric nerve fiber bundle map was built by dividing the visual field area into 21 zones. Mean deviation and pattern standard deviation values within these 21 zones were compared with OCT RNFL thickness measurements in 12 sectors and the results were analyzed. RESULTS Average RNFL thickness was 62.90+/-16.56 microm in the glaucoma group and 111.90+/-6.00 microm in the control group (P<0.05). Pattern standard deviation and mean deviation visual field zones and corresponding OCT RNFL thickness sectors were significantly correlated at specific sectors in the glaucoma group (P<0.01). CONCLUSIONS Analysis of RNFL thickness in eyes with focal glaucomatous visual field defects showed good structural and functional correlation with OCT. OCT contributes to the identification of focal defects in the RNFL of glaucoma patients.
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Screening for Glaucoma. Ophthalmology 2009. [DOI: 10.1016/b978-0-323-04332-8.00182-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Palimkar A, Khandekar R, Venkataraman V. Prevalence and distribution of glaucoma in central India (Glaucoma Survey 2001). Indian J Ophthalmol 2008; 56:57-62. [PMID: 18158405 PMCID: PMC2636061 DOI: 10.4103/0301-4738.37597] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Purpose: A community-based survey was conducted in Rajnandangaon district of Chhattisgarh state of
central India in 2001 to assess the prevalence of glaucoma in the age group of ≥35 years. Design: Community-based cross-sectional survey Materials and Methods: Ophthalmologists measured ocular pressure using Perkins applanation tonometer.
Best corrected visual acuity was checked by ETDRS chart. After dilating the pupil the fundus was examined.
A sketch diagram was drawn to note glaucomatous changes in optic disc and the surrounding retina. The
field of vision was tested on Bjerrum screen. Gonioscopy was performed to determine type of glaucoma.
Persons and their relatives were interviewed to find out risk factors and glaucoma treatment in the past. Results: Seven thousand four hundred and thirty-eight (87.3%) persons were examined. The age-sex
standardized prevalence of glaucoma was 3.68% (95% CI 3.27 to 4.07). Gender variation of glaucoma was not
significant. [OR = 1.13 (CI 95% 0.88 to 1.44)] Glaucoma varied significantly by age groups. (Χ2 = 48.2, degree of
freedom = 3 P <0.001) Among those patients diagnosed to suffer from glaucoma, the proportion of open angle,
closed angle, secondary glaucoma, ocular hypertension and glaucoma suspects was 13.1%, 21.2%, 21.2%,
14.5% and 30% respectively. Different types of visual disabilities were associated with glaucoma. However,
unilateral blindness in glaucoma was unusual. Twenty-five per cent of the glaucoma cases were detected for
the first time during the survey. Conclusions: The prevalence of glaucoma was high and the angle closure type was more compared to the
open angle glaucoma.
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Affiliation(s)
- Anand Palimkar
- Eye and Ear Health Care, NCD, DGHA, Ministry of Health, Muscat, Oman
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Analysis of Retinal Nerve Fiber Layer and Macular Thickness Measurements in Healthy Taiwanese Individuals Using Optical Coherence Tomography (Stratus OCT). J Glaucoma 2008; 17:30-5. [DOI: 10.1097/ijg.0b013e31811243b4] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
While it is often said that structural damage due to glaucoma precedes functional damage, it is not always clear what this statement means. This review has two purposes: first, to show that a simple linear relationship describes the data relating a particular functional test (standard automated perimetry (SAP)) to a particular structural test (optical coherence tomography (OCT)); and, second, to propose a general framework for relating structural and functional damage, and for evaluating if one precedes the other. The specific functional and structural tests employed are described in Section 2. To compare SAP sensitivity loss to loss of the retinal nerve fiber layer (RNFL) requires a map that relates local field regions to local regions of the optic disc as described in Section 3. When RNFL thickness in the superior and inferior arcuate sectors of the disc are plotted against SAP sensitivity loss (dB units) in the corresponding arcuate regions of the visual field, RNFL thickness becomes asymptotic for sensitivity losses greater than about 10dB. These data are well described by a simple linear model presented in Section 4. The model assumes that the RNFL thickness measured with OCT has two components. One component is the axons of the retinal ganglion cells and the other, the residual, is everything else (e.g. glial cells, blood vessels). The axon portion is assumed to decrease in a linear fashion with losses in SAP sensitivity (in linear units); the residual portion is assumed to remain constant. Based upon severe SAP losses in anterior ischemic optic neuropathy (AION), the residual RNFL thickness in the arcuate regions is, on average, about one-third of the premorbid (normal) thickness of that region. The model also predicts that, to a first approximation, SAP sensitivity in control subjects does not depend upon RNFL thickness. The data (Section 6) are, in general, consistent with this prediction showing a very weak correlation between RNFL thickness and SAP sensitivity. In Section 7, the model is used to estimate the proportion of patients showing statistical abnormalities (worse than the 5th percentile) on the OCT RNFL test before they show abnormalities on the 24-2 SAP field test. Ignoring measurement error, the patients with a relatively thick RNFL, when healthy, will be more likely to show significant SAP sensitivity loss before statistically significant OCT RNFL loss, while the reverse will be true for those who start with an average or a relatively thin RNFL when healthy. Thus, it is important to understand the implications of the wide variation in RNFL thickness among control subjects. Section 8 describes two of the factors contributing to this variation, variations in the position of blood vessels and variations in the mapping of field regions to disc sectors. Finally, in Sections 7 and 9, the findings are related to the general debate in the literature about the relationship between structural and functional glaucomatous damage and a framework is proposed for understanding what is meant by the question, 'Does structural damage precede functional damage in glaucoma?' An emphasis is placed upon the need to distinguish between "statistical" and "relational" meanings of this question.
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Affiliation(s)
- Donald C Hood
- Department of Psychology, Columbia University, 116th and Broadway, New York, NY, 10027-7004, USA.
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Lin SC, Singh K, Jampel HD, Hodapp EA, Smith SD, Francis BA, Dueker DK, Fechtner RD, Samples JS, Schuman JS, Minckler DS. Optic nerve head and retinal nerve fiber layer analysis: a report by the American Academy of Ophthalmology. Ophthalmology 2007; 114:1937-49. [PMID: 17908595 PMCID: PMC3780976 DOI: 10.1016/j.ophtha.2007.07.005] [Citation(s) in RCA: 84] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2007] [Revised: 05/24/2007] [Accepted: 07/05/2007] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE To evaluate the current published literature on the use of optic nerve head (ONH) and retinal nerve fiber layer (RNFL) measurement devices in diagnosing open-angle glaucoma and detecting progression. METHODS A search of peer-reviewed literature was conducted on February 15, 2006 in PubMed and the Cochrane Library for the period January 2003 to February 2006. The search was limited to studies of adults in English-language journals and yielded 442 citations. The panel reviewed the abstracts of these articles and selected 159 articles of possible clinical relevance for review. Of these 159 full-text articles, 82 were determined to be relevant for the first author and methodologist to review and rate according to the quality of evidence. RESULTS There were no studies classified as having the highest level of evidence (level I). The ONH and RNFL imaging instruments reviewed in this assessment were determined to be highly effective in distinguishing eyes with glaucomatous visual field (VF) loss from normal eyes without VF loss, based on level II evidence. In addition, some studies demonstrated that parameters from ONH or RNFL imaging predicted the development of VF defects among glaucoma suspects. Studies on detecting glaucoma progression showed that although there was often agreement on progression between the structural and functional (VF) tests, a significant proportion of glaucoma patients progressed by either the structural or the functional test alone. CONCLUSIONS The ONH and RNFL imaging devices provide quantitative information for the clinician. Based on studies that have compared the various available technologies directly, there is no single imaging device that outperforms the others in distinguishing patients with glaucoma from controls. Ongoing advances in imaging and related software, as well as the impracticalities associated with obtaining and assessing optic nerve stereophotographs, have made imaging increasingly important in many practice settings. The information obtained from imaging devices is useful in clinical practice when analyzed in conjunction with other relevant parameters that define glaucoma diagnosis and progression.
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Hood DC, Anderson S, Rouleau J, Wenick AS, Grover LK, Behrens MM, Odel JG, Lee AG, Kardon RH. Retinal nerve fiber structure versus visual field function in patients with ischemic optic neuropathy. A test of a linear model. Ophthalmology 2007; 115:904-10. [PMID: 17870170 PMCID: PMC2987576 DOI: 10.1016/j.ophtha.2007.06.001] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2007] [Revised: 06/01/2007] [Accepted: 06/01/2007] [Indexed: 11/28/2022] Open
Abstract
PURPOSE To test a linear model relating the regional loss in retinal nerve fiber (RNFL) thickness to the corresponding regional loss in sensitivity with data from patients with previous anterior ischemic optic neuropathy (AION). DESIGN Case-control study. PARTICIPANTS Twenty-four individuals with AION and 20 with normal vision were tested. The time since the AION attack ranged from 5.2 months to more than 20.3 years (median, 2.95 years). METHODS Eyes were tested with standard automated perimetry (SAP) and with optical coherence tomography (OCT), both RNFL thickness scans. The average RNFL thickness of the inferior and superior disc sectors was plotted against the average total deviations (linear units) of the corresponding superior and inferior arcuate field regions, and a linear model was fitted. According to the model, the RNFL thickness R=s(o)T+b, (1), where T is the relative SAP sensitivity loss (on a linear scale; e.g., for -3 dB, T = 0.5), s(o) is the RNFL thickness attributable to axons in the healthy or normal state (T = 1.0), and b is the residual RNFL measured when all sensitivity and axons are lost. MAIN OUTCOME MEASURES Optical coherence tomography RNFL thickness and SAP sensitivity. RESULTS The data from the AION patients resembled the data from glaucoma patients previously tested and were described by the linear model. For patients with SAP losses of more than -10 dB in the arcuate region, the RNFL thickness provided an estimate of residual RNFL thickness, b. The median value of b (45.5 microm) was similar to the value for patients with glaucoma. It varied among individuals (range, 30.4-63.3 microm), showing a very weak correlation with patient's age (r = 0.30) and the time since the AION episode (r = 0.26), but an excellent correlation (r(2) = 0.94; P<0.01) with the value of s(o), estimated from the unaffected eyes. CONCLUSIONS The relationship between a structure (OCT RNFL thickness) and function (SAP sensitivity loss) is the same for patients with AION and glaucoma and can be approximated by a simple linear model. The model may provide a framework for identifying those patients with ganglion cell axons that are malfunctioning but are alive.
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Affiliation(s)
- Donald C Hood
- Department of Psychology, Columbia University, New York, New York 10027-7004, USA.
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Zysk AM, Nguyen FT, Oldenburg AL, Marks DL, Boppart SA. Optical coherence tomography: a review of clinical development from bench to bedside. JOURNAL OF BIOMEDICAL OPTICS 2007; 12:051403. [PMID: 17994864 DOI: 10.1117/1.2793736] [Citation(s) in RCA: 203] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
Since its introduction, optical coherence tomography (OCT) technology has advanced from the laboratory bench to the clinic and back again. Arising from the fields of low coherence interferometry and optical time- and frequency-domain reflectometry, OCT was initially demonstrated for retinal imaging and followed a unique path to commercialization for clinical use. Concurrently, significant technological advances were brought about from within the research community, including improved laser sources, beam delivery instruments, and detection schemes. While many of these technologies improved retinal imaging, they also allowed for the application of OCT to many new clinical areas. As a result, OCT has been clinically demonstrated in a diverse set of medical and surgical specialties, including gastroenterology, dermatology, cardiology, and oncology, among others. The lessons learned in the clinic are currently spurring a new set of advances in the laboratory that will again expand the clinical use of OCT by adding molecular sensitivity, improving image quality, and increasing acquisition speeds. This continuous cycle of laboratory development and clinical application has allowed the OCT technology to grow at a rapid rate and represents a unique model for the translation of biomedical optics to the patient bedside. This work presents a brief history of OCT development, reviews current clinical applications, discusses some clinical translation challenges, and reviews laboratory developments poised for future clinical application.
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Affiliation(s)
- Adam M Zysk
- University of Illinois at Urbana-Champaign, Beckman Institute for Advanced Science and Technology, Department of Electrical and Computer Engineering, Biophotonics Imaging Laboratory, 405 North Mathews Avenue, Urbana, Illinois 61801, USA
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Johnson ZK, Siddiqui MAR, Azuara-Blanco A. The Quality of Reporting of Diagnostic Accuracy Studies of Optical Coherence Tomography in Glaucoma. Ophthalmology 2007; 114:1607-12. [PMID: 17434589 DOI: 10.1016/j.ophtha.2006.11.036] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2006] [Revised: 11/17/2006] [Accepted: 11/28/2006] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To evaluate the quality of reporting of diagnostic accuracy studies using optical coherence tomography (OCT) in glaucoma. DESIGN Descriptive series of published studies. PARTICIPANTS Published studies reporting a measure of the diagnostic accuracy of OCT for glaucoma. METHODS Review of English language papers reporting measures of diagnostic accuracy of OCT for glaucoma. Papers were identified from a Medline literature search performed in June 2006. Articles were appraised using the 25 items provided by the Standards for Reporting of Diagnostic Accuracy (STARD) initiative. Each item was recorded as full, partially, or not reported. MAIN OUTCOME MEASURES Degree of compliance with the STARD guidelines. RESULTS Thirty papers were appraised. Eight papers (26.7%) fully reported more than half of the STARD items. The lowest number of fully reported items in a study was 5 and the highest was 17. Descriptions of key aspects of methodology frequently were missing. For example, details of participant sampling (e.g., consecutive or random selection) were described in only 8 (26.7%) of 30 publications. Measures of statistical uncertainty were reported in 18 (60%) of 30 publications. No single STARD item was fully reported by all the papers. CONCLUSIONS The standard of reporting of diagnostic accuracy studies in glaucoma using OCT was suboptimal. It is hoped that adoption of the STARD guidelines will lead to an improvement in reporting of diagnostic accuracy studies, enabling clearer evidence to be produced for the usefulness of OCT for the diagnosis of glaucoma.
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Affiliation(s)
- Zoë K Johnson
- Department of Ophthalmology, Grampian University Hospitals National Health Service Trust, Aberdeen, United Kingdom
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Hougaard JL, Heijl A, Bengtsson B. Glaucoma detection using different Stratus optical coherence tomography protocols. ACTA ACUST UNITED AC 2006; 85:251-6. [PMID: 17343690 DOI: 10.1111/j.1600-0420.2006.00826.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To examine and compare the diagnostic accuracy of retinal nerve fibre layer (RNFL) thickness measurements using different Stratus optical coherence tomography (OCT) scanning protocols. METHODS Stratus OCT data for 90 healthy subjects and 62 glaucoma patients with mild or moderate visual field loss were prospectively collected and analysed using four RNFL thickness protocols that differed in terms of image resolution and number of scans. Cut-off levels corrected for age and refractive error were defined by reference values derived from an independent normal database. Sensitivity and specificity were calculated for average RNFL thickness for the full circle scan, and for the quadrant and clock hour circle scan sectors at p < 5% and p < 1% cut-off values. RESULTS Regular- and high-resolution images performed equally well, and single best-quality scans were as good as the average of three scans to distinguish between healthy and glaucomatous eyes. Full circle RNFL thickness yielded similar or better diagnostic accuracy than that of sectors. Sensitivities ranged from 84% to 87% and specificities from 89% to 93% for full circle RNFL thickness at the p < 5% cut-off level. CONCLUSIONS The abilities of four different Stratus OCT RNFL thickness protocols to distinguish between eyes with predominantly mild glaucomatous field loss and healthy eyes were very similar. Thus diagnostic accuracy did not differ between high- and regular-resolution protocols, nor between global (full circle) and localized (sector) OCT parameters, which suggests a diffuse component in early glaucomatous RNFL damage.
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Affiliation(s)
- Jesper Leth Hougaard
- Department of Clinical Sciences, Ophthalmology, Malmö University Hospital, Lund University, Malmö, Sweden.
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Chen HY, Huang ML, Hung PT. Logistic Regression Analysis for Glaucoma Diagnosis Using Stratus Optical Coherence Tomography. Optom Vis Sci 2006; 83:527-34. [PMID: 16840878 DOI: 10.1097/01.opx.0000225893.38212.07] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
PURPOSES The purposes of this study are to investigate the diagnostic performance of logistic regression analysis (LRA) applied to multidimensional information on glaucoma disease and to determine the area under receiver operator characteristic curves (AROCs) for differentiating between normal and glaucomatous eyes in the Taiwan Chinese population based on the summary data from the Stratus Optical Coherence Tomography (OCT). METHODS One randomly selected eye from each of the 89 patients with glaucoma and from each of the 88 age- and gender-matched normal individuals were included in the study. Nine glaucomatous eyes and eight normal eyes were excluded as a result of poor OCT scans. Finally, 80 normal eyes and 80 glaucomatous eyes (mean deviation, -4.5 +/- 4.12 dB) were analyzed. The whole dataset was split into four equal sets. Each set combines 20 patients with glaucoma and 20 normal individuals. Fourfold crossvalidation was conducted. Retinal nerve fiber layer thickness and optic nerve head were measured by Stratus OCT in each patient. Twenty-five OCT parameters were included in a LRA method to determine the best combination of parameters for discriminating between glaucomatous and healthy eyes based on AROCs. RESULTS With the LRA method, the AROC for glaucoma detection was 0.911 with sensitivity at 80% and 90% specificity were 83.7% and 80.0%, respectively. CONCLUSIONS Compared with the OCT-provided parameters, the LRA method improved the ability to differentiate between normal and glaucomatous eyes in the Taiwan Chinese population.
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Affiliation(s)
- Hsin-Yi Chen
- Glaucoma Service, Department of Ophthalmology, China Medical University Hospital, Taichung, Taiwan.
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Costa RA, Skaf M, Melo LAS, Calucci D, Cardillo JA, Castro JC, Huang D, Wojtkowski M. Retinal assessment using optical coherence tomography. Prog Retin Eye Res 2006; 25:325-53. [PMID: 16716639 DOI: 10.1016/j.preteyeres.2006.03.001] [Citation(s) in RCA: 134] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2006] [Indexed: 02/01/2023]
Abstract
Over the 15 years since the original description, optical coherence tomography (OCT) has become one of the key diagnostic technologies in the ophthalmic subspecialty areas of retinal diseases and glaucoma. The reason for the widespread adoption of this technology originates from at least two properties of the OCT results: on the one hand, the results are accessible to the non-specialist where microscopic retinal abnormalities are grossly and easily noticeable; on the other hand, results are reproducible and exceedingly quantitative in the hands of the specialist. However, as in any other imaging technique in ophthalmology, some artifacts are expected to occur. Understanding of the basic principles of image acquisition and data processing as well as recognition of OCT limitations are crucial issues to using this equipment with cleverness. Herein, we took a brief look in the past of OCT and have explained the key basic physical principles of this imaging technology. In addition, each of the several steps encompassing a third generation OCT evaluation of retinal tissues has been addressed in details. A comprehensive explanation about next generation OCT systems has also been provided and, to conclude, we have commented on the future directions of this exceptional technique.
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Affiliation(s)
- Rogério A Costa
- U.D.A.T.-Retina Diagnostic and Treatment Division, Hospital de Olhos de Araraquara, Rua Padre Duarte 989 ap 172, Araraquara, SP 14801 310, Brazil.
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Manassakorn A, Nouri-Mahdavi K, Caprioli J. Comparison of retinal nerve fiber layer thickness and optic disk algorithms with optical coherence tomography to detect glaucoma. Am J Ophthalmol 2006; 141:105-115. [PMID: 16386983 DOI: 10.1016/j.ajo.2005.08.023] [Citation(s) in RCA: 78] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2005] [Revised: 08/05/2005] [Accepted: 08/05/2005] [Indexed: 02/01/2023]
Abstract
PURPOSE To compare the performance of the retinal nerve fiber layer (RNFL) thickness and optic disk algorithms as determined by optical coherence tomography to detect glaucoma. DESIGN Observational cross-sectional study. METHODS setting: Academic tertiary-care center. study population: One eye from 42 control subjects and 65 patients with open-angle glaucoma with visual acuity of > or =20/40, and no other ocular pathologic condition. observation procedures: Two optical coherence tomography algorithms were used: "fast RNFL thickness" and "fast optic disk." main outcome measures: Area under the receiver operating characteristic curves and sensitivities at fixed specificities were used. Discriminating ability of the average RNFL thickness and RNFL thickness in clock-hour sectors and quadrants was compared with the parameters that were derived from the fast optic disk algorithm. Classification and regression trees were used to determine the best combination of parameters for the detection of glaucoma. RESULTS The average visual field mean deviation (+/-SD) was 0.0 +/- 1.3 and -5.3 +/- 5.0 dB in the control and glaucoma groups, respectively. The RNFL thickness at the 7 o'clock sector, inferior quadrant, and the vertical C/D ratio had the highest area under the receiver operating characteristic curves (0.93 +/- 0.02, 0.92 +/- 0.03, and 0.90 +/- 0.03, respectively). At 90% specificity, the best sensitivities (+/-SE) from each algorithm were 86% +/- 3% for RNFL thickness at the 7 o'clock sector and 79% +/- 4% for horizontal integrated rim width (estimated rim area). The combination of inferior quadrant RNFL thickness and vertical C/D ratio achieved the best classification (misclassification rate, 6.2%). CONCLUSION The fast optic disk algorithm performs as well as the fast RNFL thickness algorithm for discrimination of glaucoma from normal eyes. A combination of the two algorithms may provide enhanced diagnostic performance.
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Affiliation(s)
- Anita Manassakorn
- Glaucoma Division, Jules Stein Eye Institute, University of California-Los Angeles, 100 Stein Plaza, Los Angeles, CA 90095, USA
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Abstract
Confocal scanning laser tomography (HRT), scanning laser polarimetry (GDx VCC), and optical coherence tomography provide quantitative data of the retinal fiber layer and optic nerve head. They have become good complementary evaluation tools for glaucomatous optic neuropathy and their results should be analyzed with clinical data. Good knowledge of the parameters they analyze and their limitations are indispensable. To monitor progression of structural involvement, the analysis programs used need to be validated with prospective clinical studies.
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Affiliation(s)
- J-P Renard
- Clinique Ophtalmologique, Hôpital du Val de Grâce, Paris
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