Influences of the inner retinal sublayers and analytical areas in macular scans by spectral-domain OCT on the diagnostic ability of early glaucoma.

Abstract

We investigated the influences of the inner retinal sublayers and analytical areas in macular scans by spectral-domain optical coherence tomography (OCT) on the diagnostic ability of early glaucoma. A total of 64 early (including 24 preperimetric) glaucomatous and 40 normal eyes underwent macular and peripapillary retinal nerve fiber layer (pRNFL) scans (3D-OCT-2000). The area under the receiver operating characteristics (AUC) for glaucoma diagnosis was determined from the average thickness of the total 100 grids (6 × 6 mm), central 44 grids (3.6 × 4.8 mm), and peripheral 56 grids (outside of the 44 grids), and for each macular sublayer: macular RNFL (mRNFL), ganglion cell layer plus inner plexiform layer (GCL/IPL), and mRNFL plus GCL/IPL (ganglion cell complex [GCC]). Correlation of OCT parameters with visual field parameters was evaluated by Spearman's rank correlation coefficients (rs). The GCC-related parameters had a significantly larger AUC (0.82-0.97) than GCL/IPL (0.81-0.91), mRNFL-related parameters (0.72-0.94), or average pRNFL (0.88) in more than half of all comparisons. The central 44 grids had a significantly lower AUC than other analytical areas in GCC and mRNFL thickness. Conversely, the peripheral 56 grids had a significantly lower AUC than the 100 grids in GCL/IPL inferior thickness. Inferior thickness of GCC (rs, 0.45-0.49) and mRNFL (rs, 0.43-0.51) showed comparably high correlations with central visual field parameters to average pRNFL thickness (rs, 0.41, 0.47) even in the central 44 grids. The diagnostic ability of macular OCT parameters for early glaucoma differed by inner retinal sublayers and also by the analytical areas studied.