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. 2015 Jan;159(1):193-201.
doi: 10.1016/j.ajo.2014.10.019. Epub 2014 Oct 22.

Diagnostic ability of retinal nerve fiber layer imaging by swept-source optical coherence tomography in glaucoma

Zhiyong Yang  1 , Andrew J Tatham  1 , Linda M Zangwill  1 , Robert N Weinreb  1 , Chunwei Zhang  2 , Felipe A Medeiros  3
Affiliations

Diagnostic ability of retinal nerve fiber layer imaging by swept-source optical coherence tomography in glaucoma

Zhiyong Yang et al. Am J Ophthalmol. 2015 Jan.

Abstract

Purpose: To evaluate the diagnostic accuracies of swept-source optical coherence tomography (OCT) wide-angle and peripapillary retinal nerve fiber layer (RNFL) thickness measurements for glaucoma detection.

Design: Cross-sectional case-control study.

Methods: In this study we enrolled 144 glaucomatous eyes of 106 subjects and 66 eyes of 42 healthy subjects from the Diagnostic Innovations in Glaucoma Study. Glaucoma was defined by the presence of repeatable abnormal standard automated perimetry results and/or progressive glaucomatous optic disc change on masked grading of stereophotographs. Wide-angle and peripapillary RNFL thicknesses were assessed using swept-source OCT. Peripapillary RNFL thickness was also evaluated using spectral-domain OCT. Areas under the receiver operating characteristic (ROC) curves were calculated to evaluate the ability of the different swept-source OCT and spectral-domain OCT parameters to discriminate between glaucomatous and healthy eyes.

Results: Mean (± standard deviation) average spectral-domain OCT wide-angle RNFL thicknesses were 50.5 ± 5.8 μm and 35.0 ± 9.6 μm in healthy and glaucomatous eyes, respectively (P < 0.001). Corresponding values for swept-source OCT peripapillary RNFL thicknesses were 103.5 ± 12.3 μm and 72.9 ± 16.5 μm, respectively (P < 0.001). Areas under the ROC curves of swept-source OCT wide-angle and peripapillary RNFL thickness were 0.88 and 0.89, respectively. Swept-source OCT performed similar to average peripapillary RNFL thickness obtained by spectral-domain OCT (area under the ROC curve of 0.90).

Conclusion: Swept-source OCT wide-angle and peripapillary RNFL thickness measurements performed well for detecting glaucomatous damage. The diagnostic accuracies of the swept-source OCT and spectral-domain OCT RNFL imaging protocols evaluated in this study were similar.

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Figures

Figure 1
Figure 1
Swept source optical coherence tomography wide-angle scan. Top: Swept source optical coherence tomography (SS-OCT) 12×9 mm wide-angle retinal nerve fiber layer thickness map (right eye) showing measurements in each of the 108 1×1 mm squares. Bottom: representation of the retinal areas as determined for the right eye, with nasal quadrant (cyan), temporal quadrant (green), superior quadrant (purple), inferior quadrant (orange), and optic disc (red). Squares at the four corners (gray) were excluded from the calculations.
Figure 2
Figure 2
Box plots illustrating the distribution of retinal nerve fiber layer thickness measurements with the different scan protocols in glaucomatous and healthy eyes.
Figure 3
Figure 3
Receiver operating characteristic curves to discriminate glaucomatous from healthy eyes for the different scan protocols used in the study.
Figure 4
Figure 4
Example of retinal nerve fiber layer thinning in a glaucomatous eye detected by the swept source optical coherence tomography wide-angle scan. Top left, Optic disc photograph showing inferotemporal neuroretinal rim thinning. Top middle, Standard automated perimetry showing a corresponding superior visual field defect. Top right, Spectral domain optical coherence tomography scan showing retinal nerve fiber layer thinning in the inferotemporal peripapillary sector. Bottom, swept source optical coherence tomography wide-angle scan showing an inferotemporal wedge-shaped defect in the nerve fiber layer.
See this image and copyright information in PMC

References

    1. Harwerth RS, Carter-Dawson L, Smith EL, et al. Neural losses correlated with visual losses in clinical perimetry. Invest Ophthalmol Vis Sci. 2004;45(9):3152–3160. - PubMed
    1. Kass MA, Heuer DK, Higginbotham EJ, et al. The Ocular Hypertension Treatment Study: a randomized trial determines that topical ocular hypotensive medication delays or prevents the onset of primary open-angle glaucoma. Arch Ophthalmol. 2002;120(6):701–713. discussion 829-730. - PubMed
    1. Wollstein G, Schuman JS, Price LL, et al. Optical coherence tomography longitudinal evaluation of retinal nerve fiber layer thickness in glaucoma. Arch Ophthalmol. 2005;123(4):464–470. - PMC - PubMed
    1. Strouthidis NG, Scott A, Peter NM, Garway-Heath DF. Optic disc and visual field progression in ocular hypertensive subjects: detection rates, specificity, and agreement. Invest Ophthalmol Vis Sci. 2006;47(7):2904–2910. - PubMed
    1. Grewal DS, Tanna AP. Diagnosis of glaucoma and detection of glaucoma progression using spectral domain optical coherence tomography. Curr Opin Ophthalmol. 2013;24(2):150–161. - PubMed

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