Abstract
Purpose To examine the influence of optic disc size on the diagnostic accuracy of optic nerve head (ONH) parameters determined by Cirrus spectral-domain optical coherence tomography (Cirrus HD-OCT). Methods A total of 51 eyes of 51 normal participants and 71 eyes of 71 glaucoma patients were examined. ONH imaging was obtained by Cirrus HD-OCT. Sensitivity at a fixed 90% specificity along with the area under the receiver operating characteristic curve (AUC) for continuous parameters were analyzed. We also examined the coefficients of variation (CoV) for sensitivity estimates, as these have been used to test and quantify the influence of optic disc size on diagnostic accuracy. The influence of optic disc size on the glaucoma diagnosis was assessed by the likelihood ratio chi-square test. Results Among the continuous parameters, the best diagnostic accuracy was seen for the average rim area, which had an AUC of 0.96. The most reliable factor across the disc size groups was the rim area (CoV, 2.8%). The diagnostic accuracy of the rim area did not appear to be influenced by optic disc size (P = 0.17). Conclusions The high diagnostic accuracy of the rim area demonstrated by Cirrus HD-OCT for the quantitative assessment of the ONH was not significantly affected by disc size in this study.
Highlights
Primary open-angle glaucoma (POAG) is a chronic disease characterized by a progressive loss of retinal ganglion cells [1]
The purpose of the current study was to examine the influence of the optic nerve head (ONH) size on the diagnostic accuracy of the ONH quantitative assessment determined by the Cirrus HD-Optical coherence tomography (OCT)
We demonstrated that the optic disc size did not influence the accuracy of the Cirrus HD-OCT when determining the ONH rim area parameter
Summary
Primary open-angle glaucoma (POAG) is a chronic disease characterized by a progressive loss of retinal ganglion cells [1] This cell loss leads to structural damage that includes a progressive regional or diffuse thinning of both the retinal nerve fiber layer (RNFL) and the neuroretinal rim within the optic nerve head (ONH), followed by functional loss, as shown by progressive visual field defects [2]. It has been demonstrated that larger optic discs are associated with lower specificities, while smaller discs are associated with lower sensitivities [11,12,13,14] These can potentially limit the role of quantitative ONH assessments during the clinical diagnostic process. The purpose of the current study was to examine the influence of the ONH size on the diagnostic accuracy of the ONH quantitative assessment determined by the Cirrus HD-OCT
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