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. 2016 Apr;64(4):277-84.
doi: 10.4103/0301-4738.182938.

Optic nerve head parameters of high-definition optical coherence tomography and Heidelberg retina tomogram in perimetric and preperimetric glaucoma

Viquar Unnisa Begum  1 , Uday Kumar Addepalli  1 , Sirisha Senthil  1 , Chandra Sekhar Garudadri  1 , Harsha Laxmana Rao  1
Affiliations

Optic nerve head parameters of high-definition optical coherence tomography and Heidelberg retina tomogram in perimetric and preperimetric glaucoma

Viquar Unnisa Begum et al. Indian J Ophthalmol. 2016 Apr.

Abstract

Background: Heidelberg retina tomogram (HRT) and optical coherence tomography (OCT) are two widely used imaging modalities to evaluate the optic nerve head (ONH) in glaucoma.

Purpose: To compare the ONH parameters of HRT3 and high-definition OCT (HD-OCT) and evaluate their diagnostic abilities in perimetric and preperimetric glaucoma.

Design: Cross-sectional analysis.

Methods: 35 control eyes (24 subjects), 21 preperimetric glaucoma eyes (15 patients), and 64 perimetric glaucoma eyes (44 patients) from the Longitudinal Glaucoma Evaluation Study underwent HRT3 and HD-OCT examinations.

Statistical analysis: Agreement between the ONH parameters of HRT and HD-OCT were assessed using Bland-Altman plots. Diagnostic abilities of ONH parameters were evaluated using area under the receiver operating characteristic curves (AUCs), sensitivity at fixed specificity, and likelihood ratios (LR).

Results: Optic disc area, vertical cup to disc ratio, and cup volume with HD-OCT were larger than with HRT, while the rim area was smaller with HD-OCT (P < 0.001 for all comparisons). AUCs of all HD-OCT ONH parameters (0.90-0.97 in perimetric and 0.62-0.71 in preperimetric glaucoma) were comparable (P > 0.10) to the corresponding HRT ONH parameters (0.81-0.95 in perimetric and 0.55-0.72 in preperimetric glaucoma). LRs associated with diagnostic categorization of ONH parameters of both HD-OCT and HRT were associated with larger effects on posttest probability of perimetric compared to preperimetric glaucoma.

Conclusions: ONH measurements of HD-OCT and HRT3 cannot be used interchangeably. Though the diagnostic abilities of ONH parameters of HD-OCT and HRT in glaucoma were comparable, the same were significantly lower in preperimetric compared to perimetric glaucoma.

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Figures

Figure 1
Figure 1
Venn diagram showing the number of eyes excluded from analysis because of poor quality disc photographs, unreliable visual fields, and poor quality high-definition optical coherence tomography and Heidelberg retina tomogram images
Figure 2
Figure 2
Bland–Altman plots showing the agreement between high-definition optical coherence tomography and Heidelberg retina tomography for (a) disc area, (b) rim area, (c) vertical cup-disc ratio, and (d) cup volume parameters
Figure 3
Figure 3
Receiver operating characteristic curves of the optic nerve head parameters of high-definition optical coherence tomography (solid lines) and Heidelberg retina tomography (dashed lines) in perimetric and preperimetric glaucoma
See this image and copyright information in PMC

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