Comparison of diagnostic accuracy of Fourier‐domain optical coherence tomography and scanning laser polarimetery to detect glaucoma

Abstract

Abstract Purpose To compare diagnostic accuracy of retinal nerve fiber layer thickness (RNFLT) measurements made using RTVue‐100 Fourier‐domain optical coherence tomography (RTVue‐OCT) and scanning laser polarimetry with variable (GDx‐VCC) or enhanced compensation (GDx‐ECC). Methods One eye of each of 177 consecutive patients was imaged. Healthy (n=50) and ocular hypertensive (n=28) eyes were defined as normal, preperimetric (n=33) perimetric (n=66) glaucoma eyes as diseased. Results For average RNFLT sensitivity was higher (Chi‐square test, p=0.002) with RTVue‐OCT (65.7 %) than with GDx‐VCC (49.5 %). For superior and inferior RNFLT sensitivity was similar with all methods. For the different nerve fiber bundle parameters, sensitivity of RTVue‐OCT (64.6 to 84.8 %) was consistently, up to 35 % higher (p<0.001) than that of GDx‐VCC/ECC (28.3 to 72.7 %). Specificity ranged 84.6 to 98.7 % with RTVue‐OCT, 92.3 to 100 % with GDx‐VCC, and 94.9 to 100 % with GDx‐ECC, with no significant difference between the methods except for one nerve fiber bundle parameter, for which RTVue‐OCT was less specific than either GDx method (p≤0.004). Diagnostic accuracy of the GDx‐VCC/ECC nerve fiber indicator (NFI) and RTVue‐OCT average RNFLT were similar. Of the detected glaucoma cases 87.7 % was identified both by GDx‐VCC/ECC NFI and average RNFLT of RTVue‐OCT. Conclusion In this clinical setting, all methods were similarly highly specific, but for localized RNFLT damage RTVue‐OCT was statistically and clinically significantly more sensitive than GDx‐VCC and GDx‐ECC. Most detected glaucoma cases were identified with all three methods. Commercial interest