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Yun Jeong Choi, Mi Jeung Kim, Kyoung Nam Kim, Jin Wook Jeoung, Ki Ho Park, Dong Myung Kim; Comparison between deviation map of circumpapillary retinal nerve fiber layer and macular ganglion cell-inner plexiform layer measurements using high-definition optical coherence tomography in the detection of early glaucoma. Invest. Ophthalmol. Vis. Sci. 2013;54(15):2286.
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To compare the sensitivity and specificity of the deviation map of circumpapillary retinal nerve fiber layer (cpRNFL) and macular ganglion cell-inner plexiform layer (GCIPL) measurements using high-definition optical coherence tomography (Cirrus HD-OCT) for discriminating between healthy control and early glaucoma patients.
We prospectively enrolled 171 early glaucoma patients confirmed by two reliable visual field tests (mean deviation > -6 dB) and 114 healthy control subjects. Abnormal cpRNFL and macular GCIPL deviation maps corresponding to visual field defects represented as red (P < 1%) or yellow (P < 5%) superpixels were used to calculate the sensitivity and specificity (%). We used three different criteria for deviation map abnormality: a cluster of three or more contiguous yellow in the same hemifield on the deviation map, including one or more red ones (criteria 1): a cluster of five or more yellow superpixels, including three or more red (criteria 2): a cluster of ten or more yellow superpixels, including five or more red (criteria 3). Sensitivity differences were determined by McNemar test.
The early glaucoma detection sensitivities of the cpRNFL deviation map were 92.7% (95% confidence interval (CI): 88.5 - 96.9%) for criteria 1, 90.1% (95% CI: 85.7 - 94.5%) for criteria 2, and 88.0% (95% CI: 83.1 - 92.9%) for criteria 3. The specificities were 54.4% (95% CI: 45.1 - 63.7 %), 64.9% (95% CI: 56.0 - 73.8%), and 76.3% (95% CI: 68.4 - 84.2%), respectively. The sensitivities of the macular GCIPL deviation map were 90.4% (95% CI: 86.1 - 94.7%) for criteria 1, 87.4% (95% CI: 82.5 - 92.3%) for criteria 2, and 85.1% (95% CI: 79.8 - 90.4%) for criteria 3. The specificities were 59.6% (95% CI: 50.5 - 68.7%), 69.3% (95% CI: 60.7 - 77.9%), and 76.3% (95% CI: 68.4 - 84.2%), respectively. The sensitivity difference between the cpRNFL and macular GCIPL deviation maps was not statistically significant for any of the three abnormality criteria (P > 0.05).
The deviation map of macular GCIPL measurement by Cirrus HD-OCT showed similar early glaucoma detection sensitivities to that of the cpRNFL deviation map. On this basis, the macular GCIPL deviation map can be considered to be a complementary glaucoma diagnostic test.
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