Abstract
Purpose
To compare the diagnostic abilities of peripapillary retinal nerve fiber layer (RNFL) and macular inner retina (MIR) measurements by spectral domain optical coherence tomography (SD–OCT) in Indian eyes early glaucoma.
Methods
In an observational, cross-sectional study, 125 eyes of 64 normal subjects and 91 eyes of 59 early glaucoma patients underwent RNFL and MIR imaging with SD–OCT. Glaucomatous eyes had characteristic optic nerve and RNFL abnormalities and correlating visual field defects and a mean deviation of better than or equal to -6 dB on standard automated perimetry. Areas under the receiver operating characteristic curves (AUC), sensitivities at a fixed specificity and likelihood ratios (LRs) were estimated for all RNFL and MIR parameters.
Results
The AUCs for the RNFL parameters ranged from 0.537 for the temporal quadrant thickness to 0.821 for the inferior quadrant RNFL thickness. AUCs for the MIR parameters ranged from 0.603 for the superior minus inferior MIR thickness average to 0.908 for ganglion cell complex focal loss volume (GCC–FLV). AUC for the best MIR parameter (GCC–FLV) was significantly better (P<0.001) than that of the best RNFL parameter (inferior quadrant thickness). The sensitivities of these parameters at high specificity of 95%, however, were comparable (52.7% vs58.2%). Evaluation of the LRs showed that outside normal limits results of most of the RNFL and MIR parameters were associated with large effects on the post-test probability of disease.
Conclusion
MIR parameters with RTVue SD–OCT were as good as the RNFL parameters to detect early glaucoma.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
References
Medeiros FA, Zangwill LM, Bowd C, Vessani RM, Susanna Jr R, Weinreb RN . Evaluation of retinal nerve fiber layer, optic nerve head, and macular thickness measurements for glaucoma detection using optical coherence tomography. Am J Ophthalmol 2005; 139: 44–55.
Wollstein G, Ishikawa H, Wang J, Beaton SA, Schuman JS . Comparison of three optical coherence tomography scanning areas for detection of glaucomatous damage. Am J Ophthalmol 2005; 139: 39–43.
Hougaard JL, Heijl A, Bengtsson B . Glaucoma detection by Stratus OCT. J Glaucoma 2007; 16: 302–306.
Parikh RS, Parikh S, Sekhar GC, Kumar RS, Prabakaran S, Babu JG et al. Diagnostic capability of optical coherence tomography (Stratus OCT 3) in early glaucoma. Ophthalmology 2007; 114: 2238–2243.
Nouri-Mahdavi K, Nikkhou K, Hoffman DC, Law SK, Caprioli J . Detection of early glaucoma with optical coherence tomography (StratusOCT). J Glaucoma 2008; 17: 183–188.
Nassif N, Cense B, Park B, Pierce M, Yun S, Bouma B et al. In vivo high-resolution video-rate spectral-domain optical coherence tomography of the human retina and optic nerve. Opt Express 2004; 12: 367–376.
Wojtkowski M, Srinivasan V, Ko T, Fujimoto J, Kowalczyk A, Duker J . Ultrahigh-resolution, high-speed, Fourier domain optical coherence tomography and methods for dispersion compensation. Opt Express 2004; 12: 2404–2422.
Zeimer R, Asrani S, Zou S, Quigley H, Jampel H . Quantitative detection of glaucomatous damage at the posterior pole by retinal thickness mapping. A pilot study. Ophthalmology 1998; 105: 224–231.
Curcio CA, Allen KA . Topography of ganglion cells in human retina. J Comp Neurol 1990; 300: 5–25.
Tan O, Chopra V, Lu AT, Schuman JS, Ishikawa H, Wollstein G et al. Detection of macular ganglion cell loss in glaucoma by Fourier-domain optical coherence tomography. Ophthalmology 2009; 116: 2305–2314, e2301–2302.
Rao HL, Zangwill LM, Weinreb RN, Sample PA, Alencar LM, Medeiros FA . Comparison of different spectral domain optical coherence tomography scanning areas for glaucoma diagnosis. Ophthalmology 2010; 117: 1692–1699, 1699, e1691.
Mori S, Hangai M, Sakamoto A, Yoshimura N . Spectral-domain optical coherence tomography measurement of macular volume for diagnosing glaucoma. J Glaucoma 2010; 19: 528–534.
Garas A, Vargha P, Hollo G . Diagnostic accuracy of nerve fibre layer, macular thickness and optic disc measurements made with the RTVue-100 optical coherence tomograph to detect glaucoma. Eye (Lond) 2011; 25: 57–65.
Schulze A, Lamparter J, Pfeiffer N, Berisha F, Schmidtmann I, Hoffmann EM . Diagnostic ability of retinal ganglion cell complex, retinal nerve fiber layer, and optic nerve head measurements by Fourier-domain optical coherence tomography. Graefes Arch Clin Exp Ophthalmol 2011; 249: 1039–1045.
Medeiros FA, Zangwill LM, Bowd C, Sample PA, Weinreb RN . Influence of disease severity and optic disc size on the diagnostic performance of imaging instruments in glaucoma. Invest Ophthalmol Vis Sci 2006; 47: 1008–1015.
Garudadri CS, Rao HL, Parikh RS, Jonnadula GB, Selvaraj P, Nutheti R et al. Effect of Optic Disc Size and Disease Severity on the Diagnostic Capability of Glaucoma Imaging Technologies in an Indian Population. J Glaucoma 2011; e-pub ahead of print 25 April 2011; doi:10.1097/IJG.0b013e31821829f1.
Rao HL, Leite MT, Weinreb RN, Zangwill LM, Alencar LM, Sample PA et al. Effect of disease severity and optic disc size on diagnostic accuracy of RTVue spectral domain optical coherence tomograph in glaucoma. Invest Ophthalmol Vis Sci 2011; 52: 1290–1296.
Seong M, Sung KR, Choi EH, Kang SY, Cho JW, Um TW et al. Macular and peripapillary retinal nerve fiber layer measurements by spectral domain optical coherence tomography in normal-tension glaucoma. Invest Ophthalmol Vis Sci 2010; 51: 1446–1452.
Hodapp E PR, Anderson DR (eds). Clinical Decisions in Glaucoma. St. Louis, 1993; pp 53.
Zhou X-H ON, McClish DK . Analysis of correlated ROC data. In: Zhou X-H, Obuchowski NA, McClish DK (eds). Statistical Methods in Diagnostic Medicine. John Wiley & Sons, Inc: New York, 2002; pp 274–306.
Alonzo TA, Pepe MS . Distribution-free ROC analysis using binary regression techniques. Biostatistics 2002; 3: 421–432.
Jaeschke R, Guyatt GH, Sackett DL . Users’ guides to the medical literature. III. How to use an article about a diagnostic test. B. What are the results and will they help me in caring for my patients? The Evidence-Based Medicine Working Group. JAMA 1994; 271: 703–707.
Radack KL, Rouan G, Hedges J . The likelihood ratio. An improved measure for reporting and evaluating diagnostic test results. Arch Pathol Lab Med 1986; 110: 689–693.
Fagan TJ . Letter: Nomogram for Bayes theorem. N Engl J Med 1975; 293: 257.
Simel DL, Samsa GP, Matchar DB . Likelihood ratios with confidence: sample size estimation for diagnostic test studies. J Clin Epidemiol 1991; 44: 763–770.
Langlotz CP . Fundamental measures of diagnostic examination performance: usefulness for clinical decision making and research. Radiology 2003; 228: 3–9.
Medeiros FA, Zangwill LM, Bowd C, Weinreb RN . Comparison of the GDx VCC scanning laser polarimeter, HRT II confocal scanning laser ophthalmoscope, and stratus OCT optical coherence tomograph for the detection of glaucoma. Arch Ophthalmol 2004; 122: 827–837.
Zangwill LM, Jain S, Racette L, Ernstrom KB, Bowd C, Medeiros FA et al. The effect of disc size and severity of disease on the diagnostic accuracy of the Heidelberg Retina Tomograph Glaucoma Probability Score. Invest Ophthalmol Vis Sci 2007; 48: 2653–2660.
Huang JY, Pekmezci M, Mesiwala N, Kao A, Lin S . Diagnostic Power of Optic Disc Morphology, Peripapillary Retinal Nerve Fiber Layer Thickness, and Macular Inner Retinal Layer Thickness in Glaucoma Diagnosis With Fourier-domain Optical Coherence Tomography. J Glaucoma 2011; 20: 87–95.
Lijmer JG, Mol BW, Heisterkamp S, Bonsel GJ, Prins MH, van der Meulen JH et al. Empirical evidence of design-related bias in studies of diagnostic tests. JAMA 1999; 282: 1061–1066.
Medeiros FA, Ng D, Zangwill LM, Sample PA, Bowd C, Weinreb RN . The effects of study design and spectrum bias on the evaluation of diagnostic accuracy of confocal scanning laser ophthalmoscopy in glaucoma. Invest Ophthalmol Vis Sci 2007; 48: 214–222.
Acknowledgements
Dr Garudadri received RTVue as a research grant from Optovue for Indian normative database collection.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
Drs Rao and Garudadri are consultants to Allergan. Dr Garudadri is also a consultant to Merck and Alcon. Dr Garudadri received RTVue as a research grant from Optovue for Indian normative database collection. The other manuscript authors have no financial interest in any of the products mentioned in the study.
Additional information
Meeting presentation: Association for Research in Vision and Ophthalmology 2010 and American Academy of Ophthalmology 2010
Rights and permissions
About this article
Cite this article
Rao, H., Babu, J., Addepalli, U. et al. Retinal nerve fiber layer and macular inner retina measurements by spectral domain optical coherence tomograph in Indian eyes with early glaucoma. Eye 26, 133–139 (2012). https://doi.org/10.1038/eye.2011.277
Received:
Accepted:
Published:
Issue date:
DOI: https://doi.org/10.1038/eye.2011.277
Keywords
This article is cited by
-
Predicting the central 10 degrees visual field in glaucoma by applying a deep learning algorithm to optical coherence tomography images
Scientific Reports (2021)
-
Management of the regression of papilledema with regional axon loss in idiopathic intracranial hypertension patients
International Ophthalmology (2021)
-
Structural and functional assessment of macula to diagnose glaucoma
Eye (2017)
-
The association between structure-function relationships and cognitive impairment in elderly glaucoma patients
Scientific Reports (2017)
-
Retinal nerve fiber layer evaluation of spectral domain optical coherence tomograph and scanning laser polarimeter to diagnose glaucoma
Eye (2014)
