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Editors Selection IGR 13-3
Optical Coherence Tomography: Diagnostic performance SD-OCT
Comment by Marco Vizzeri on:
27756 Predictors of Normal Optic Nerve Head, Retinal Nerve Fiber Layer, and Macular Parameters Measured by Spectral Domain Optical Coherence Tomography, Rao HL; Kumar AU; Babu JG et al., Investigative Ophthalmology and Visual Science, 2011; 52: 1103-1110
It is no secret that the diagnostic performance of the current tests used for glaucoma detection varies along the disease continuum. With imaging devices, for example, signs of glaucomatous structural damage are easier to detect at more advanced stages of the disease. Rao et al. (183) elegantly demonstrated that such is the case for RTVue Spectral Domain Optical Coherence Tomography. The study indicates that the diagnostic performance of RTVue parameters is significantly affected by disease severity, with increased sensitivity at more severe stages of the disease.
It is no secret that the diagnostic performance of the current tests used for glaucoma detection varies along the disease continuum
RNFL thickness and ganglion cell complex measurements displayed a similar trend, with superior diagnostic accuracy compared to optic disc parameters. However, disc size, as measured using the HRT disc area, did not seem to have a significant influence on the diagnostic capabilities of RTVue. It is unclear whether the study was originally designed to evaluate the effect of optic disc size and whether it was adequately powered for this purpose. Nonetheless, it is conceivable that, in larger discs with larger cups, optic disc parameters may be more sensitive, although less specific in detecting glaucoma, with little change in the overall diagnostic accuracy of the instrument. The authors did not report whether age, one of the variables previously known to influence the diagnostic accuracy of visual function tests in glaucoma, also has a significant influence on RTVue parameters. In the future, a larger sample size might allow for the evaluation of more variables, as well as for possible interactions between them. Further studies should also determine whether RTVue can be used to detect subtle glaucomatous structural changes over time, thus resulting in improved diagnostic performance at early stages of the disease.
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