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Abstract #59543 Published in IGR 16-3
Population-based evaluation of retinal nerve fiber layer, retinal ganglion cell layer, and inner plexiform layer as a diagnostic tool for glaucoma
Springelkamp H; Lee K; Wolfs RC; Buitendijk GH; Ramdas WD; Hofman A; Vingerling JR; Klaver CC; Abràmoff MD; Jansonius NMInvestigative Ophthalmology and Visual Science 2014; 0:
PURPOSE: To determine the glaucoma screening performance of regional OCT layer thickness measurements in the peripapillary and macular region, in a population-based setting. METHODS: Subjects (n=1,224) in the Rotterdam Study underwent visual field testing (Humphrey Field Analyzer) and OCT of macula and optic nerve head (Topcon 3-D OCT-1000). We determined the mean thicknesses of the RNFL, retinal ganglion cell layer (RGCL), and inner plexiform layer for regions-of-interest, thus defining a series of OCT parameters, using the Iowa Reference Algorithms. Reference standard was the presence of glaucomatous visual field loss (GVFL); controls were subjects without GVFL, an IOP of 21 mmHg or less, and no positive family history for glaucoma. We calculated the area under the receiver operating characteristics curve (AUCs) and the sensitivity at 97.5% specificity for each parameter. RESULTS: After excluding 23 subjects with an IOP >21 mmHg and 73 subjects with a positive family history for glaucoma, there were 1,087 controls and 41 glaucoma cases. Mean RGCL thickness in the inferior half of the macular region showed the highest AUC (0.85; 95% confidence interval 0.77-0.92) and sensitivity (53.7%; 38.7-68.0%). The mean thickness of the peripapillary RNFL had an AUC of 0.77 (0.69-0.85) and a sensitivity of 24.4% (13.7-39.5%). CONCLUSIONS: Macular RGCL loss is at least as common as peripapillary RNFL abnormalities in population-based glaucoma cases. OCT based screening for glaucoma identifies about half of those cases of glaucoma diagnosed by perimetry.
Departments of Ophthalmology and Epidemiology, Erasmus Medical Center, Rotterdam, Netherlands.
Full articleClassification:
6.9.2.2 Posterior (Part of: 6 Clinical examination methods > 6.9 Computerized image analysis > 6.9.2 Optical coherence tomography)
2.13 Retina and retinal nerve fibre layer (Part of: 2 Anatomical structures in glaucoma)
