Diagnostic Performance of Optical Coherence Tomography for Pseudoexfoliation Glaucoma.

Abstract

Lamina cribrosa (LC) thickness and LC curvature index (LCCI) had comparable diagnostic performances with retinal nerve fiber layer (RNFL) thickness in distinguishing eyes with pseudoexfoliation glaucoma (PXG) from those with pseudoexfoliation syndrome (PXS). Bruch's membrane opening-minimum rim width (BMO-MRW) showed the lowest diagnostic performance among all geometric parameters derived from optical coherence tomography (OCT) scans we evaluated. The aim was to compare the diagnostic performance of different geometric parameters derived from OCT scans (RNFL thickness, LC thickness, LCCI, and BMO-MRW) for distinguishing eyes with PXG from PXS and healthy eyes. Fifty-five eyes of 55 patients with PXG, 55 eyes of 55 patients with PXS, and 50 healthy subjects were enrolled in this cross-sectional study. The areas under the receiver operating characteristic curves (AUCs) of RNFL thickness, LC thickness, LCCI and BMO-MRW were calculated and compared. In discriminating between eyes with PXG from those with PXS, LC thickness [0.930; 95% confidence interval (CI): 0.883-0.978] and global RNFL thickness (0.974; 95% CI: 0.947-0.992) presented comparable AUCs ( P =0.244). In distinguishing subjects with PXG from healthy controls, both LC thickness (0.972; 95% CI: 0.948-0.997) and LCCI (0.983; 95% CI: 0.968-0.998) had comparable AUCs with global RNFL thickness (0.988; 95% CI: 0.974-1.000) ( P =0.094 and 0.239, respectively). Global BMO-MRW had lower AUCs than RNFL thickness (0.839; 95% CI: 0.759-0.920 and 0.897; 95% CI: 0.836-0.958, respectively) in distinguishing PXG from both PXS and healthy controls ( P =0.001 and 0.002, respectively). BMO-MRW also had significantly lower AUCs than both LC thickness and LCCI in distinguishing PXG from healthy controls ( P =0.034 and 0.001, respectively). LC thickness and LCCI had better diagnostic performance than BMO-MRW in distinguishing PXG from PXS and healthy controls, which were comparable to RNFL thickness.