Discriminating ability of optical coherence tomography data in staging glaucomatous damage

Abstract

Objective: To evaluate the ability of retinal nerve fibre layer (RNFL) thickness and optic nerve head (ONH) measurements, as determined by optical coherence tomography (OCT), to discriminate between normal eyesight and glaucoma and also among the different stages of glaucoma. Design: Observational cross-sectional study. Participants: Eighty-one controls and 213 glaucoma patients were enrolled in the study. Methods: The discriminating powers of OCT parameters for the detection of glaucoma and subgroups were compared by the area under the receiver operating characteristic (AUROC) curves. Results: The best RNFL thickness parameters for discriminating between early glaucoma and control eyes were inferior (0.74 [SE 0.04] μm), average (0.74 [SD 0.03] μm), and superior (0.68 [SD 0.03] μm). Among the ONH parameters, the best AUROC curve values were cup area (0.83 [SD 0.33]), cup/disc (C/D) area ratio (0.82 [SD 0.03]), and vertical integrated rim area (VIRA) (0.82 [SD 0.03]). The best AUROC values belonged to the RNFL thickness and were inferior (0.80 [SD 0.03]), superior (0.79 [SD 0.03]), and 6 o’clock (0.78 [SD 0.03]). The highest AUROC values were horizontal integrated rim width (HIRW) (0.74 [SD 0.04]), VIRA (0.64 [SD 0.04]), and rim area (0.63 [SD 0.04]) among the ONH parameters for early versus moderate glaucoma. The best AUROC values were inferior (0.81 [SD 0.03]), 6 o’clock (0.79 [SD 0.03]), and superior (0.78 [SD 0.04]) among the RNFL, and the best AUROC values were cup area (0.81 [SD 0.03]),VIRA (0.81 [SD 0.03]), and C/D area ratio (0.80 [SD 0.03]) among the ONH parameters, for moderate versus advanced glaucoma. Conclusions: RNFL and ONH OCT parameters might provide information for determining glaucomatous damage.