J Korean Ophthalmol Soc.  2015 Sep;56(9):1400-1407. 10.3341/jkos.2015.56.9.1400.

Diagnostic Ability of Spectral Domain OCT: Comparision between Preperimetric Glaucoma and Large Physiologic Cupping

• Jeong JS
• Kim NR

• KMID: 2214556
• DOI: http://doi.org/10.3341/jkos.2015.56.9.1400

Abstract

PURPOSE
To assess the distinction ability for differentiating glaucoma patients based on optic disc, retinal nerve fiber layer (RNFL) and ganglion cell-inner plexiform layer (GCIPL) measured using spectral domain optical coherence tomography (SD-OCT). Additionally, the diagnostic ability of these parameters was evaluated by comparing preperimetic glaucoma patients who frequently visited the clinic and normal patients with and without a large physiologic cup/disc (C/D) ratio.
METHODS
Using SD-OCT, the optic disc, RNFL and GCIPL of preperimetic glaucoma patients were compared with normal people with and without a large C/D ratio from March, 2011 to December, 2014 at Department of Ophthalmology, Inha University Hospital. Preperimetic glaucoma was defined using the normal standard automated perimetry for glaucomatous optic nerve changes such as asymmetry of vertical C/D ratio, rim thinning, notching, excavation and RNFL defect.
RESULTS
When comparing preperimetic glaucoma patients to normal people without large disc cupping, the most reliable parameter for optic disc parameters, vertical C/D ratio (0.89), showed more reliable diagnostic ability than the most reliable parameter for retinal nerve fiber, inferior RNFL thickness (0.79) and superonasal and inferonasal GCIPL thickness were the most reliable GCIPL parameters (p = 0.005 and 0.002, respectively). When comparing preperimetic glaucoma patients to normal people having a large physiologic disc cupping, average C/D ratio among optic nerve parameters, inferior RNFL thickness among RNFL thickness parameters and inferior GCIPL thickness among GCIPL parameters showed highly reliable diagnostic abilities. These 3 parameters were not statistically different (all p > 0.05) and had lower distinction ability than reported in previous studies.
CONCLUSIONS
Diagnostic abilities of SD-OCT for distinguishing preperimetric glaucoma from normal people having large physiologic disc cupping were similar for optic disc, RNFL and GCIPL and showed low diagnostic ability than compared to normal people without large disc cupping.

Keyword

Diagnostic ability; Large physiologic cupping; Preperimetric glaucoma; Spectral domain OCT

MeSH Terms

Ganglion Cysts
Glaucoma*
Humans
Nerve Fibers
Ophthalmology
Optic Nerve
Retinaldehyde
Tomography, Optical Coherence
Visual Field Tests
Retinaldehyde

Figure

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  Figure 1. Comparision of receiver operating curves between ONH, RNFL and GCIPL parameters. (A) AUROC values: 0.89 in VCDR, 0.72 in Inf RNFL, 0.70 in GCIPL. The difference between VCDR and Inf RNFL, VCDR and Inferotemp GCIPL were stat-istically significant ( p < 0.001, DeLong method). (B) AUROC values: 0.72 in Inf RNFL, 0.70 in Avg CDR, 0.67 in Inf GCIPL. The difference between Inf RNFL and Avg CDR and Inf GCIPL were not statistically significant ( p > 0.05, DeLong method). ONH = optic nerve head; RNFL = retinal nerve fiber layer; GCIPL = ganglion cell inner plexiform layer; AUROC = area under receiver operating curve; VCDR = vertical cup-disc ratio; Inf RNFL = inferior retinal nerve fiber layer; Inferotemp = in-ferotemporal; Avg CDR = average cup-to-disc ratio; Inf GCIPL = inferior ganglion cell inner plexiform layer.

Reference

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