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. 2021 May;69(5):1108-1112.
doi: 10.4103/ijo.IJO_2409_20.

Comparison of diagnostic ability of standard automated perimetry, short wavelength automated perimetry, retinal nerve fiber layer thickness analysis and ganglion cell layer thickness analysis in early detection of glaucoma

V Ks Kalyani  1 , Khurshed M Bharucha  1 , Nikhil Goyal  2 , Madan M Deshpande  1
Affiliations

Comparison of diagnostic ability of standard automated perimetry, short wavelength automated perimetry, retinal nerve fiber layer thickness analysis and ganglion cell layer thickness analysis in early detection of glaucoma

V Ks Kalyani et al. Indian J Ophthalmol. 2021 May.

Abstract

Purpose: The aim of this study was to compare the diagnostic ability of macular ganglion cell layer (GCL) analysis using spectral domain optical coherence tomography against retinal nerve fiber layer analysis (RNFL), short-wavelength automated perimetry (SWAP), and standard automated perimetry (SAP) in early detection of glaucoma.

Methods: Participants fulfilling the inclusion criteria were consecutively enrolled from the glaucoma clinic of tertiary care eye hospital in Western India from November 2015 to October 2016. The subjects underwent a detailed evaluation by trained glaucoma specialists. On suspicion of glaucoma, the patients underwent SAP, SWAP, and SD-OCT for GCL and RNFL analysis.

Results: There were 91 patients in total of which experts classified 54 eyes into GON and 37 eyes into nonglaucomatous group. Sensitivity of SAP (42.59%) was significantly lower (P < 0.05) than that of average GCL thickness (79.63%) and average RNFL thickness (72.22%). Specificity and positive LR of SWAP (97.3% and 19.19, respectively) and SAP (94.6% and 7.88, respectively) were greater than those of GCL (81.08% and 4.21) and RNFL (67.57% and 2.23) parameters. Negative LR of average GCL thickness (0.25) was superior to that of average RNFL thickness (0.411), SWAP (0.495), and SAP (0.607).

Conclusion: Macular GCL parameters perform better than RNFL parameters in patients with early glaucomatous damage. There is superior ability of SWAP over SAP in detecting glaucomatous changes in glaucoma suspect group. GCL thickness analysis has higher sensitivity and negative likelihood ratio, whereas SWAP had higher specificity and positive likelihood ratio. Thus, combining both tests can lead to better diagnostic ability for early glaucomatous damage.

Keywords: Diagnostic ability; ganglion cell layer; glaucoma; retinal nerve fiber layer; short-wavelength automated perimetry; spectral-domain optical coherence tomography; standard automated perimetry.

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Conflict of interest statement

None

References

    1. Le PV, Tan O, Chopra V, Francis BA, Ragab O, Varma R, et al. Regional correlation among ganglion cell complex, nerve fiber layer, and visual field loss in glaucoma. Invest Opthalmol Vis Sci. 2013;54:4287–95. - PMC - PubMed
    1. Kim S, Lee JY, Kim SO, Kook MS. Macular structure–function relationship at various spatial locations in glaucoma. Br J Ophthalmol. 2015;99:1412–8. - PubMed
    1. Halpern DL, Grosskreutz CL. Glaucomatous optic neuropathy:Mechanisms of disease. Ophthalmol Clin North Am. 2002;15:61–8. - PubMed
    1. Sit AJ, Medeiros FA, Weinreb RN. Short-wavelength automated perimetry can predict glaucomatous standard visual field loss by ten years. Semin Ophthalmol. 2004;19:122–4. - PubMed
    1. Raza AS, Zhang X, De Moraes CGV, Reisman CA, Liebmann JM, Ritch R, et al. Improving glaucoma detection using spatially correspondent clusters of damage and by combining standard automated perimetry and optical coherence tomography. Invest Opthalmol Vis Sci. 2014;55:612–24. - PMC - PubMed