Abstract
ObjectiveTo analyse the morphological features and diagnostic ability of eight macular retinal layers using a new segmentation software Heidelberg's Spectralis Optical Coherence Tomography (SD-OCT) in healthy, ocular hypertensive and primary open angle glaucoma patients.MethodsSingle-center, cross-sectional, non-interventional study. 193 eyes from 193 consecutive patients (56 controls, 63 ocular hypertensives, 32 early primary open glaucoma patients and 42 moderate-advanced primary open glaucoma patients). Those patients presenting any retinal disease were excluded. Macular segmentation of the retinal layers was automatically performed using the new segmentation Heidelberg's Spectralis OCT software providing measurements for eight retinal layers. The software provides thickness maps divided into nine subfields.ResultsStatistically significant differences in inner layers’ thickness was found between all 4 four groups. Superior and inferior sectors of macular retinal nerve fiber layer; nasal, temporal, superior and inferior sectors of ganglion cell layer and inner plexiform layer were significantly different when comparing ocular hypertensive patients and early glaucoma patients. Areas under the ROC curves for early glaucoma diagnosis were 0.781±0.052 for macular retinal nerve fiber layer outer inferior sector, 0.760±0.050 for ganglion cell layer outer temporal sector, 0.767±0.049 for the inner plexiform layer outer temporal sector and 0.807±0.048 for the combination of all three. No differences were found between groups when considering outer retinal layers.ConclusionsThe automated segmentation software from Heidelberg's Spectralis OCT provides a new diagnostic tool for the diagnosis of ocular hypertensive and glaucoma patients.
Highlights
Glaucoma is still the second leading cause of blindness worldwide [1]
Tests performed for the diagnosis of glaucoma include intraocular pressure (IOP) measurement, visual field (VF) tests [6], stereo and red-free photographs [7] and more recently, structural analysis tests like optical coherence tomography (OCT) [8], which grants a more precise and reliable analysis of the optic nerve and peripapillary retinal nerve fiber layer [9,10]
Recent studies have shown that macular measurements with Spectral Domain (SD) OCT were as good as the peripapillary retinal nerve fiber layer (pRNFL) measurements in detecting glaucoma [18,19,20,21,22,23]
Summary
Glaucoma is still the second leading cause of blindness worldwide [1]. Its multifactorial etiology leads to a progressive loss of retinal ganglion cells (RCG) [2,3] and a reduction in the patients’ visual field (VF) [4,5].Diagnostic tools for glaucoma have evolved during the years seeking to learn more about this disease and to improve methods to analyse its progression. Its multifactorial etiology leads to a progressive loss of retinal ganglion cells (RCG) [2,3] and a reduction in the patients’ visual field (VF) [4,5]. Tests performed for the diagnosis of glaucoma include intraocular pressure (IOP) measurement, VF tests [6], stereo and red-free photographs [7] and more recently, structural analysis tests like optical coherence tomography (OCT) [8], which grants a more precise and reliable analysis of the optic nerve and peripapillary retinal nerve fiber layer (pRNFL) [9,10]. Recent studies have shown that macular measurements with Spectral Domain (SD) OCT were as good as the pRNFL measurements in detecting glaucoma [18,19,20,21,22,23]
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