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Abstract #78159 Published in IGR 19-4
The Optimal Diameter for Circumpapillary Retinal Nerve Fiber Layer Thickness Measurement by SD-OCT in Glaucoma
Heindl LM; Adler W; El-Malahi O; Schaub F; Hermann MM; Dietlein TS; Cursiefen C; Enders PJournal of Glaucoma 2018; 0:
PURPOSE: To evaluate the diagnostic power for glaucoma detection using circumpapillary retinal nerve fiber layer (cRNFL) thickness in three diameter sizes from the center of the optic nerve head (ONH) by spectral domain optical coherence tomography (SD-OCT). METHODS: In this cross-sectional study, case-control, 437 eyes diagnosed with glaucoma and 183 eyes of healthy controls underwent SD-OCT of the ONH, visual field testing, and a clinical examination. Circumpapillary RNFL thickness (cRNFL) was measured by circular scans in 3.5▒mm (C1), 4.2▒mm (C2) and 4.7▒mm (C3) distance from the center of the ONH. Receiver operating characteristics (ROC) analysis was used to assess diagnostic power to detect glaucoma; furthermore, patient-specific maximum localized damage was analysed. RESULTS: In C1, mean global cRNFL was 70.03±18.2▒μm in glaucomatous eyes and 93.46±9.9▒μm in controls. Respectively, cRNFL in C2 was 61.39±14.9▒μm and 80.43±8.4▒μm as well as 55.25±12.8▒μm and 70.70±6.7▒μm in C3. Using ROC analysis, the area under the curve (AUC) for cRNFL was 0.855 in C1, 0.850 in C2, and 0.843 in C3. Mean AUCs in ONH sectors ranged from 0.699 to 0.846 and did not exceed AUC of the best scoring global parameter. CONCLUSIONS: Comparing 3.5-mm, 4.2-mm and 4.7-mm diameters for cRNFL measurement, the inner circle at 3.5mm distance showed the highest AUC to differentiate glaucoma from healthy controls. However, levels of diagnostic power from wider circular scans were not significantly different and were comparable. Also, sectorial cRNFL measurements were non-superior. The use of the ONH sector with the highest localized damage seems not to increase diagnostic power.
Department of Ophthalmology, University Hospital of Cologne, Kerpener Strasse 62, 50924 Cologne, Germany.
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)
