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Observational Study
. 2014 Dec 23;9(12):e116115.
doi: 10.1371/journal.pone.0116115. eCollection 2014.

Factors affecting the ability of the spectral domain optical coherence tomograph to detect photographic retinal nerve fiber layer defects

Harsha L Rao  1 , Uday K Addepalli  1 , Ravi K Yadav  1 , Nikhil S Choudhari  1 , Sirisha Senthil  1 , Chandra S Garudadri  1
Affiliations
Observational Study

Factors affecting the ability of the spectral domain optical coherence tomograph to detect photographic retinal nerve fiber layer defects

Harsha L Rao et al. PLoS One. .

Abstract

Purpose: To evaluate the ability of normative database classification (color-coded maps) of spectral domain optical coherence tomograph (SDOCT) in detecting wedge shaped retinal nerve fiber layer (RNFL) defects identified on photographs and the factors affecting the ability of SDOCT in detecting these RNFL defects.

Methods: In a cross-sectional study, 238 eyes (476 RNFL quadrants) of 172 normal subjects and 85 eyes (103 RNFL quadrants with wedge shaped RNFL defects) of 66 glaucoma patients underwent RNFL imaging with SDOCT. Logistic regression models were used to evaluate the factors associated with false positive and false negative RNFL classifications of the color-coded maps of SDOCT.

Results: False positive classification at a p value of <5% was seen in 108 of 476 quadrants (22.8%). False negative classification at a p value of <5% was seen in 16 of 103 quadrants (15.5%). Of the 103 quadrants with RNFL defects, 64 showed a corresponding VF defect in the opposite hemisphere and 39 were preperimetric. Higher signal strength index (SSI) of the scan was less likely to have a false positive classification (odds ratio: 0.97, p = 0.01). Presence of an associated visual field defect (odds ratio: 0.17, p = 0.01) and inferior quadrant RNFL defects as compared to superior (odds ratio: 0.24, p = 0.04) were less likely to show false negative classifications.

Conclusions: Scans with lower signal strengths were more likely to show false positive RNFL classifications, and preperimetric and superior quadrant RNFL defects were more likely to show false negative classifications on color-coded maps of SDOCT.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Example of a false positive classification on color-coded map of spectral domain optical coherence tomograph (SDOCT).
Left panel shows the red free fundus photograph of an eye with healthy retinal nerve fiber layer (RNFL). Middle panel shows normal pattern deviation probability plot of the same eye. Right panel shows the color-coded RNFL map of SDOCT showing abnormal RNFL both in superotemporal (ST, at p<5%) and inferotemporal (IT, at p<1%) quadrants.
Figure 2
Figure 2. Example of a false negative classification on color-coded map of spectral domain optical coherence tomograph (SDOCT).
Left panel shows the red free fundus photograph of an eye with superotemporal retinal nerve fiber layer (RNFL) defect. Middle panel shows the corresponding visual field defect in the inferior hemisphere on the pattern deviation probability plot of the same eye. Right panel shows the color-coded RNFL map of SDOCT showing normal RNFL in superotemporal (ST) quadrant.
Figure 3
Figure 3. Predicted probability of false positive classification of retinal nerve fiber layer defects on spectral domain optical coherence tomograph with different signal strength index values.
See this image and copyright information in PMC

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