J Korean Ophthalmol Soc.  2017 Jul;58(7):836-845. 10.3341/jkos.2017.58.7.836.

Diagnostic Accuracies of Bruch Membrane Opening-minimum Rim Width and Retinal Nerve Fiber Layer Thickness in Glaucoma

• Kim SH
• Park KH
• Lee JW

• KMID: 2387158
• DOI: http://doi.org/10.3341/jkos.2017.58.7.836

Abstract

PURPOSE
To compare the diagnostic capability of Bruch membrane opening-minimum rim width (BMO-MRW) and peripapillary retinal nerve fiber layer (RNFL) thickness for the detection of primary open angle glaucoma.
METHODS
Spectral-domain optical coherence tomography (SD-OCT) with 24 radial and 1 peripapillary B-scans centered on the Bruch membrane opening (BMO) was performed. Two SD-OCT parameters were computed globally and sectorally: (1) BMO-MRW, the minimum distance between BMO and internal limiting membrane; and (2) peripapillary retinal nerve fiber layer (RNFL) thickness. The diagnostic performance of BMO-MRW and RNFL thickness were compared with receiver operating characteristic (ROC) analysis globally and sectorally. Areas under the ROC (AUC) were calculated and compared.
RESULTS
One hundred fourteen eyes (52 healthy, 62 glaucomatous) of 114 participants were included. In global analyses, the performance of BMO-MRW was similar to that of RNFL thickness (AUC 0.95 [95% confidence interval {CI}, 0.91-0.99], and 0.95 [95% CI, 0.91-0.99], respectively, p=0.93). In sectoral analyses, the pair-wise comparison among the ROC curves showed no statistical difference for all sectors except for the superotemporal, superonasal, and nasal sectors, which had significantly larger AUCs in BMO-MRW compared to RNFL thickness (p=0.03, p<0.001, and p=0.03, respectively). The parameter with the largest AUC was the inferotemporal sector for both BMO-MRW and RNFL thickness (AUC 0.98 [95% CI, 0.96-1.00], and 0.98 [95% CI, 0.96-1.00], respectively, p=0.99).
CONCLUSIONS
Global BMO-MRW performed as well as global RNFL thickness for detection of glaucoma. In superotemporal, superonasal and nasal sectors, regional BMO-MRW performed better than regional RNFL thickness.

Keyword

Bruch membrane opening-minimum rim width; Diagnostic capability; Peripapillary retinal nerve fiber layer thickness; Spectral-domain optical coherence tomography

MeSH Terms

Area Under Curve
Bruch Membrane*
Glaucoma*
Glaucoma, Open-Angle
Membranes
Nerve Fibers*
Retinaldehyde*
ROC Curve
Tomography, Optical Coherence
Retinaldehyde

Figure

• 

  Figure 1. Neuroretinal rim parameters measured with Spectralis optical coherence tomography. B-scan illustrating Bruch mem-brane opening (BMO), and Bruch membrane opening-minimum rim width (BMO-MRW), the minimum distance from BMO to the internal limiting membrane (ILM).

• 

  Figure 2. The receiver operating characteristic (ROC) curves. ROC curves illustrating the diagnostic performance of global Bruch membrane opening-minimum rim width (BMO-MRW) and retinal nerve fiber layer thickness (RNFLT).

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  Figure 3. The receiver operating characteristic curves illustrating the diagnostic performance of sectoral Bruch membrane opening-minimum rim width (BMO-MRW) and retinal nerve fiber layer thickness (RNFLT). (A) Superonasal. (B) Nasal. (C) Inferonasal. (D) Superotemporal. (E) Temporal. (F) Inferotemporal.

Reference

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