Abstract
PurposeTo compare the abilities of spectral-domain optical coherence tomography (OCT) (SD-OCT; Spectralis, Heidelberg Engineering) and swept-source OCT (SS-OCT; DRI-OCT1 Atlantis system, Topcon) for analyzing the macular inner retinal layers in diagnosing glaucoma.MethodsThe study included 60 patients with primary open-angle glaucoma (POAG) and 60 healthy control subjects. Macular cube area was scanned using SD-OCT and SS-OCT on the same day to assess the thicknesses of the macular retinal nerve fiber layer (mRNFL), ganglion cell layer plus inner plexiform layer (GCIPL), and total retinal layer in nine subfields defined by the Early Treatment Diabetic Retinopathy Study (ETDRS). The abilities of the parameters to discriminate between the POAG and control groups were assessed using areas under the receiver operating characteristic curves (AUCs).ResultsGlaucoma-associated mRNFL and GCIPL thinning was more common in the outer zones than inner zones for both SD-OCT and SS-OCT. The mRNFL and GCIPL measurements showed distinct pattern differences between SD-OCT and SS-OCT in each ETDRS subfield. Although the glaucoma-diagnosis ability was comparable between SD-OCT and SS-OCT for most of the parameters, AUC was significantly larger for SD-OCT measurements of the GCIPL thickness in the outer temporal zones (p = 0.003) and of the mRNFL thickness in the outer nasal zones (p = 0.001), with the former having the largest AUC for discriminating POAG from healthy eyes (AUC = 0.894).ConclusionSpectralis SD-OCT and DRI SS-OCT have similar glaucoma-diagnosis abilities based on macular inner layer thickness analysis. However, Spectralis SD-OCT was potentially superior to DRI SS-OCT in detecting GCIPL thinning in the outer temporal zone, where the glaucomatous damage predominantly occurs.
Highlights
Glaucoma is characterized by the progressive degeneration of retinal ganglion cells (RGC) and the loss of their axons [1,2]
Glaucoma-associated macular retinal nerve fiber layer (mRNFL) and ganglion cell layer plus inner plexiform layer (GCIPL) thinning was more common in the outer zones than inner zones for both SD-optical coherence tomography (OCT) and swept-source OCT (SS-OCT)
The glaucoma-diagnosis ability was comparable between spectral-domain OCT (SD-OCT) and SSOCT for most of the parameters, areas under the receiver operating characteristic curves (AUCs) was significantly larger for SD-OCT measurements of the GCIPL thickness in the outer temporal zones (p = 0.003) and of the mRNFL thickness in the outer nasal zones (p = 0.001), with the former having the largest AUC for discriminating primary open-angle glaucoma (POAG) from healthy eyes (AUC = 0.894)
Summary
Glaucoma is characterized by the progressive degeneration of retinal ganglion cells (RGC) and the loss of their axons [1,2]. In recent decades the peripapillary retinal nerve fiber layer (RNFL) has been a major focus in OCT-based glaucoma evaluations [4,5,6,7]. Recent advances in OCT technology have enabled more detailed segmentation of the macular inner retinal layers, and allowed the quantitative evaluation of macular RGC damage [8,9,10]. Studies have shown that the thickness of the macular inner retinal layer as measured using spectral-domain OCT (SD-OCT) is useful for the diagnosis of early glaucoma [11,12,13,14] and for evaluating glaucoma progression [15,16,17]. Potential advantages of macular analysis have been suggested in patients with high myopia [18,19], parafoveal scotoma [20,21], and advanced disease [16,22]
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