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Comparative Study
. 2012 Nov;96(11):1420-5.
doi: 10.1136/bjophthalmol-2011-301021. Epub 2012 Aug 22.

Glaucoma discrimination of segmented cirrus spectral domain optical coherence tomography (SD-OCT) macular scans

Jacek Kotowski  1 , Lindsey S Folio, Gadi Wollstein, Hiroshi Ishikawa, Yun Ling, Richard A Bilonick, Larry Kagemann, Joel S Schuman
Affiliations
Comparative Study

Glaucoma discrimination of segmented cirrus spectral domain optical coherence tomography (SD-OCT) macular scans

Jacek Kotowski et al. Br J Ophthalmol. 2012 Nov.

Abstract

Aims: To evaluate the glaucoma discriminating ability of macular retinal layers as measured by spectral domain optical coherence tomography (SD-OCT).

Methods: Healthy, glaucoma suspect and glaucomatous subjects had a comprehensive ocular examination, visual field testing and SD-OCT imaging (Cirrus HD-OCT; Carl Zeiss Meditec, Dublin, California, USA) in the macular and optic nerve head regions. OCT macular scans were segmented into macular nerve fibre layer (mNFL), ganglion cell layer with inner plexiform layer (GCIP), ganglion cell complex (GCC) (composed of mNFL and GCIP), outer retinal complex and total retina. Glaucoma discriminating ability was assessed using the area under the receiver operator characteristic curve (AUC) for all macular parameters and mean circumpapillary retinal nerve fibre layer (cpRNFL).

Results: Analysis was performed on 51 healthy, 49 glaucoma suspect and 63 glaucomatous eyes. The median visual field MD was -2.21 dB (IQR: -6.92 to -0.35) for the glaucoma group, -0.32 dB (IQR: -1.22 to 0.73) for the suspect group and -0.18 dB (IQR: -0.92 to 0.71) for the healthy group. Highest age adjusted AUCs were found for average GCC and GCIP (AUC=0.901 and 0.900, respectively) and their sectoral measurements: infero-temporal (0.922 and 0.913), inferior (0.904 and 0.912) and supero-temporal (0.910 and 0.897). These values were similar to the discriminating ability of the mean cpRNFL (AUC=0.913). Comparison of these AUCs did not yield any statistically significant difference (all p>0.05).

Conclusions: SD-OCT GCIP and GCC measurements showed similar glaucoma diagnostic ability and were comparable with that of cpRNFL.

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Conflict of interest statement

Conflict of Interest Disclosures: J. Kotowski: None. L.S. Folio: None. G. Wollstein: None. L. Kagemann: None. H. Ishikawa: None. Y. Ling: None. R.A. Bilonick: None. J.S. Schuman: Royalties for intellectual property licensed by Massachusetts Institute of Technology to Carl Zeiss Meditec.

Figures

FIGURE 1
FIGURE 1
Schematic of the elliptical annulus used for data sampling within the 6mm × 6mm Cirrus HD-OCT Macular Cube 200×200 scan. The annulus has an inner vertical radius of 0.5mm and an outer vertical radius of 2mm, stretched horizontally by 20%. ST = supero-temporal; S = superior; SN = supero-nasal; IN = infero-nasal; I = inferior; IT = infero-temporal.
FIGURE 2
FIGURE 2
Example of ganglion cell complex (Top) and ganglion cell and inner plexiform layers (Bottom) maps in a healthy eye.
FIGURE 3
FIGURE 3
Example of ganglion cell complex (Top) and ganglion cell and inner plexiform layers (Center) maps in a glaucomatous eye. Thickness reduction is evident in the inferotemporal region corresponding with superior visual field defect (Bottom).
See this image and copyright information in PMC

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