Abstract
PurposeTo compare the abilities of peripapillary retinal nerve fiber layer (RNFL) parameters of spectral domain optical coherence tomograph (SDOCT) and scanning laser polarimeter (GDx enhanced corneal compensation; ECC) in detecting preperimetric glaucoma.MethodsIn a cross-sectional study, 35 preperimetric glaucoma eyes (32 subjects) and 94 control eyes (74 subjects) underwent digital optic disc photography and RNFL imaging with SDOCT and GDx ECC. Ability of RNFL parameters of SDOCT and GDx ECC to discriminate preperimetric glaucoma eyes from control eyes was compared using area under receiver operating characteristic curves (AUC), sensitivities at fixed specificities and likelihood ratios (LR).ResultsAUC of the global average RNFL thickness of SDOCT (0.786) was significantly greater (p<0.001) than that of GDx ECC (0.627). Sensitivities at 95% specificity of the corresponding parameters were 20% and 8.6% respectively. AUCs of the inferior, superior and temporal quadrant RNFL thickness parameters of SDOCT were also significantly (p<0.05) greater than the respective RNFL parameters of GDx ECC. LRs of outside normal limits category of SDOCT parameters ranged between 3.3 and 4.0 while the same of GDx ECC parameters ranged between 1.2 and 2.1. LRs of within normal limits category of SDOCT parameters ranged between 0.4 and 0.7 while the same of GDx ECC parameters ranged between 0.7 and 1.0.ConclusionsAbilities of the RNFL parameters of SDOCT and GDx ECC to diagnose preperimetric glaucoma were only moderate. Diagnostic abilities of the RNFL parameters of SDOCT were significantly better than that of GDx ECC in preperimetric glaucoma.
Highlights
Spectral domain optical coherence tomography (SDOCT) and scanning laser polarimetry (SLP) are the two currently used common imaging techniques for peripapillary retinal nerve fiber layer (RNFL) evaluation in glaucoma
SDOCT is a recent technique which enables imaging the ocular structures with higher resolution and faster scan rate compared to the previous version of this technology (Stratus OCT, Carl Zeiss Meditec, Inc., Dublin, CA) [1,2]
This was an observational, cross-sectional study of consecutive subjects referred by general ophthalmologists to a tertiary eye care facility between September 2010 and November 2012 as glaucoma suspects based on the optic disc appearance
Summary
Spectral domain optical coherence tomography (SDOCT) and scanning laser polarimetry (SLP) are the two currently used common imaging techniques for peripapillary retinal nerve fiber layer (RNFL) evaluation in glaucoma. Though numerous studies have reported good diagnostic ability of both SDOCT [7,8,9,10,11] and GDx ECC [12,13,14] in glaucoma, there is limited literature on head to head comparison of these imaging techniques in the same population [15,16] Most of these studies have employed a case-control design including glaucoma patients (cases), defined based on the presence of repeatable characteristic glaucomatous visual field (VF) defects; and normal subjects (controls), usually recruited from the general population and having normal intraocular pressures (IOP), healthy appearance of the optic nerve and normal VFs. in clinical practice, a diagnostic test is used to rule-in disease in very early stages (preferably in preperimetric stages of glaucoma) or rule-out disease in subjects suspected of having disease. The purpose of the current study was to compare the abilities of RNFL parameters of SDOCT and GDx ECC in detecting preperimetric glaucoma
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