Glaucoma Detection by Stratus OCT

Abstract

To investigate the diagnostic accuracy of retinal nerve fiber layer thickness (RNFLT) summary report parameters from Stratus optical coherence tomography (OCT) in glaucoma patients. We obtained Stratus OCT measurements of peripapillary circle scans (average values) of the regular image resolution "FAST RNFLT" protocol, and of 1 circle scan of the high resolution "RNFLT" protocol in one eye of each of 62 glaucoma patients with mild or moderate visual field (VF) loss and 90 healthy subjects. Sensitivity, specificity, and diagnostic accuracy [(true positive+true negative)/all] were evaluated for all summary report parameters including the newer (eg, "Imax," the maximum thickness point in the inferior quadrant) at the normative limits of the Stratus OCT. The diagnostic accuracy of full circle RNFLT using the 5% normal limit was 89% with the FAST RNFLT and 87% with the RNFLT protocol; this was at least as good as any other parameter. The diagnostic performance of the 2 protocols did not differ significantly for most parameters. In eyes with mild VF loss (n=39) diagnostic sensitivities reached 72% and 77% at specificities >or=95% using the FAST RNFLT and RNFLT protocol, respectively. The diagnostic accuracy of the full circle RNFLT was as good as any Stratus OCT parameter on the basis of the peripapillary RNFL thickness measurements, including localized measurements. The sensitivity was moderately high in patients with mild glaucomatous VF loss. There seems to be room for further development of OCT interpretation tools for early diagnosis of glaucoma.